Choriocarcinoma

The choriocarcinoma ( syn. choriocarcinoma ) is an infiltrative growing tumors from anaplastic trophoblast cells. The tumor occurs in women of childbearing age often after hydatidiform moles on, more rarely after miscarriage, normal pregnancy and tubal pregnancies. The choriocarcinoma is considered very aggressive tumor and metastasize early. Rare is the non- gestational choriocarcinoma of the ovary. This is a germ cell tumor that often occurs already in childhood and adolescence.

Epidemiology

The ratio of choriocarcinoma on births is in America and in Europe about 1:45.000.

The malignant tumor is often found after a Erstschwangerschaft, especially older Primapara ( primipara beyond 30 years of age ) are affected.

Approximately 50% of cases occur after a molar pregnancy on, each about 25 % after a miscarriage or during or after a normal pregnancy.

Symptoms

The symptom when choriocarcinoma are non-cyclical vaginal bleeding. Are metastases present, these symptoms can cause.

Pathogenesis

The choriocarcinoma often arises from a hydatidiform mole. The degeneracy probability is 2-17 %. Another cause an increased immune tolerance to paternal antigens is discussed.

Course

The choriocarcinoma is one of the very aggressive carcinomas. It grows invasively and destructively into the myometrium. By arodierten vessels, bleeding occurs and hematogenous metastases, particularly in the lungs, vagina, liver, kidneys and brain.

Staging

Depending on the degree of invasive growth and the presence of metastases, the following thin entities:

• Nichtmetastasierendes choriocarcinoma
• Destructive hydatidiform mole (with or without metastasis)
• Metastatic choriocarcinoma with low risk
• Metastatic choriocarcinoma with high risk

As a high risk cases IE apply with a metastasis in the lungs, pelvis, CNS or liver, or with a HCG levels greater than 100,000

Therapy

The choriocarcinoma responds very well to chemotherapy with methotrexate. Even in the early stages of metastasis, a cure is possible.

Choriocarcinoma in the male

The choriocarcinoma may rarely occur in men, then it is usually localized in the testes. See: germ cell tumor.