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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Choriocarcinoma

Chorioblastoma; Trophoblastic tumor; Chorioepithelioma; Gestational trophoblastic neoplasia

Last reviewed: June 11, 2014.

Choriocarcinoma is a fast-growing form of cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. This is the organ that develops during pregnancy to feed the fetus.

Choriocarcinoma is a type of gestational trophoblastic disease.

Causes

Choriocarcinoma is an uncommon cancer that occurs during pregnancy. A baby may or may not develop in this type of pregnancy.

The cancer may occur after a normal pregnancy. But it most often occurs with a complete hydatidiform mole. The abnormal tissue from the mole can continue to grow even after it is removed, and can turn into cancer. About half of all women with a choriocarcinoma had a hydatidiform mole, or molar pregnancy.

Choriocarcinomas may also occur after an early pregnancy that does not continue (miscarriage), or after an ectopic pregnancy or genital tumor.

Symptoms

A possible symptom is abnormal or irregular vaginal bleeding in a woman who recently had a hydatidiform mole or pregnancy.

Other symptoms may include:

Exams and Tests

A pregnancy test will be positive even if you are not pregnant. The pregnancy hormone (HCG) level will be high.

A pelvic exam may show uterine swelling or a tumor.

Blood tests that may be done include:

Imaging tests that may be done include:

  • CT scan
  • MRI

You should be carefully monitored after a hydatidiform mole or at the end of a pregnancy. Early diagnosis of choriocarcinoma can improve the outcome.

Treatment

After you are diagnosed, a careful history and exam will be done to make sure the cancer has not spread to other organs. Chemotherapy is the main type of treatment.

Hysterectomy and radiation therapy are rarely needed.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

Most women whose cancer has not spread can be cured and will still be able to have children. A choriocarcinoma may come back within a few months to 3 years after treatment.

The condition is harder to cure if the cancer has spread and one or more of the following happens:

  • Disease spreads to the liver or brain
  • Pregnancy hormone (HCG) level is higher than 40,000 milli-international units per milliliter (mIU/mL) when treatment begins
  • Cancer returns after having chemotherapy
  • Symptoms or pregnancy occurred for more than 4 months before treatment began
  • Choriocarcinoma occurred after a pregnancy that resulted in the birth of a child

Many women (about 70%) who have a poor outlook at first go into remission (a disease-free state).

When to Contact a Medical Professional

Call for an appointment with your health care provider if you develop symptoms within 1 year after a hydatidiform mole or pregnancy.

References

  1. McGee J, Covens A. Gestational trophoblastic disease: hydatidiform mole, nonmetastatic and metastatic gestational trophoblastic tumor: diagnosis and management. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 35.
  2. National Cancer Institute: PDQ Gestational Trophoblastic Disease Treatment. Bethesda, MD: National Cancer Institute. Date last modified 4/25/2014. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/gestationaltrophoblastic/HealthProfessional. Accessed June 11, 2014.

Review Date: 6/11/2014.

Reviewed by: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Combinations of anti‐cancer drugs to treat high‐risk cancers arising from the placenta, known as high‐risk gestational trophoblastic neoplasia (GTN)Combinations of anti‐cancer drugs to treat high‐risk cancers arising from the placenta, known as high‐risk gestational trophoblastic neoplasia (GTN)
    GTN is a cancer that most often arises after a molar pregnancy but can arise after any type of pregnancy. Molar pregnancies occur due to abnormal growth of placental tissue that is usually benign and treated by evacuation of the womb (D&C). However, in less than 10% of molar pregnancies in the UK, the growth remains after D&C and transforms into a cancer (GTN) that needs treatment with anti‐cancer drugs (chemotherapy). GTN can be low‐risk or high‐risk. Anti‐cancer drugs are very effective, especially in low‐risk GTN, which is usually cured with single‐drug treatment. However, high‐risk GTN needs to be treated with combinations of anti‐cancer drugs for the best effect. These drugs can produce toxic side effects that are more likely to occur when used in combination with each other. The most commonly administered drug combination is abbreviated as EMA/CO, which stands for Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide and Oncovin® (vincristine), but several other combinations are also in use.
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