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Gestational choriocarcinoma
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Gestational choriocarcinoma

Contributors: Mitchell Linder MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Gestational choriocarcinoma is a condition due to abnormal growth from placental tissue. It is often grouped under gestational trophoblastic neoplasia (GTN) and is the most aggressive form of GTN, with common metastases to the lungs, vagina, liver, and brain and is associated with elevated levels of human chorionic gonadotropin. These malignancies arise with components of both syncytiotrophoblasts and cytotrophoblasts but without chorionic villi.

Approximately 25% of initial identifications will be associated with a molar pregnancy. It is more common after having a complete, versus partial, mole. About 50% of cases will follow full-term pregnancies. Risk factors include increased age at time of pregnancy and history of a prior molar pregnancy. Incidence is approximately 1 in 40 000 pregnancies in North America and Europe.

Most cases are identified by an abnormally trending beta-human chorionic gonadotrophin (bhCG) curve following evacuation of a molar pregnancy or by the patient having abnormal postpartum bleeding. In some cases, pathologic evaluation of evacuated molar pregnancy tissue or postdelivery placenta will identify choriocarcinoma.

Codes

ICD10CM:
C58 – Malignant neoplasm of placenta

SNOMEDCT:
417570003 – Gestational choriocarcinoma

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • New pregnancy following recent surgical evacuation of a molar pregnancy
  • Other forms of GTN
  • False positive bhCG (due to certain antibodies reacting with the blood test – if concern for this, check urine hCG level, as the antibodies do not affect urine samples)

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:12/19/2019
Last Updated:12/19/2019
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Gestational choriocarcinoma
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Gestational choriocarcinoma : Abdominal pain, Abdominal mass, Elevated urine hCG level, Vaginal bleeding, Menorrhagia
Copyright © 2021 VisualDx®. All rights reserved.