How is choriocarcinoma managed?
If the choriocarcinoma is in your vagina, it could cause bleeding. If it has spread to your abdomen, you might also have pain or pressure there. If it has spread to other parts of your body like ...
What is choriocarcinoma and what causes it?
Choriocarcinoma is one of the tumors that are very responsive to chemotherapy, except for the case of choriocarcinoma in the testicles. The treatment rate is as high as 95%. Patients with no metastases have a high recovery rate. However, when metastases are already present in the brain and liver, the condition is usually fatal.
What are the possible conditions associated with poor prognosis of choriocarcinoma?
· In case the tumour is big and has spread to other parts of the body, then it will be considered high-risk and will require surgery and chemotherapy, or surgery, chemotherapy and radiation. 1. Chemotherapy. Except for a tumour in the testicles, choriocarcinoma reacts well to chemotherapy. 2.
What is the best chemotherapy for choriocarcinoma?
With treatment, survival can reach up to 90% to 95% in women 62 but the prognosis is generally poorer in men, with a 5-year survival of only 35% to 47%. 67 Patients who present with choriocarcinoma and associated hyperthyroidism overall have poorer prognosis because this suggests a larger tumor burden, with metastatic disease associated with very high hCG levels …
Why is choriocarcinoma so responsive to chemo?
Since gestational choriocarcinoma (which arises from a hydatidiform mole) contains paternal DNA (and thus paternal antigens), it is exquisitely sensitive to chemotherapy. The cure rates, even for metastatic gestational choriocarcinoma, more than 90% when using chemotherapy for invasive mole and choriocarcinoma.
Are choriocarcinoma responsive to treatment?
The outlook for someone with choriocarcinoma who receives treatment is very positive. The most common treatment is chemotherapy. Some people with the cancer will also need radiation therapy, surgery, or both.
How is choriocarcinoma treated?
If your tumor is low-risk, meaning it's small and hasn't spread, chemotherapy is the main treatment. You'll get it until there are no signs of cancer in your body based on hCG levels. If your cancer is high-risk, you may need surgery and chemo, or surgery, chemo, and radiation.
Can you survive choriocarcinoma?
Survival for persistent trophoblastic disease and choriocarcinoma is very high. Nearly all women are cured. The statistics here are intended as a general guide and can't tell you what is likely to happen in your individual case. Your doctor can give you more information about your own outlook (prognosis).
What is the survival rate of choriocarcinoma?
The complete remission rate and 5-year overall survival rate of postterm choriocarcinoma patients in our cohorts were 87.9 and 86.7 %, respectively. A history of resistance to multiagent chemotherapy, liver metastasis and a FIGO score greater than 12 were shown to be independent risk factors of prognosis.
How long can you live with choriocarcinoma?
While 5-year overall survival and cure for this population is greater than 95%, choriocarcinoma is an aggressive subtype of this disease with far worse prognosis--5-year survival for choriocarcinoma is less than 80%.
What chemotherapy is used for choriocarcinoma?
If you have high risk PTD or choriocarcinoma, you might have the drug methotrexate by drip into a vein (intravenous infusion). This is followed a week later by the drugs actinomycin and etoposide. Or you may have a combination of chemotherapy drugs called EMA-CO.
What causes choriocarcinoma?
Summary. The common cause of choriocarcinoma is abnormal tissue that develops after sperm fertilizes an egg in the body. This cancer is more likely to occur if you have a hydatidiform mole, or molar pregnancy.
Is choriocarcinoma benign or malignant?
A choriocarcinoma is a malignant tumor that forms from trophoblast cells and spreads to the muscle layer of the uterus and nearby blood vessels.
Can Stage 4 choriocarcinoma be cured?
Fortunately, most women who are found to have choriocarcinoma can be cured; treatment with a combination of chemotherapy agents such as etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristine (EMA-CO) is found to be very effective at achieving remission.
How quickly does choriocarcinoma spread?
Choriocarcinoma can develop some months or even years after pregnancy and can be difficult to diagnose, because it is so unexpected. They can grow quickly and might cause symptoms within a short period of time. They can spread to other parts of the body but are very likely to be cured by chemotherapy treatment.
What are the stages of choriocarcinoma?
Stage I: Disease is only in the uterus. Stage II: GTD extends outside the uterus but is limited to the genital structures. Stage III: GTD extends to the lungs and may or may not involve the genital tract. Stage IV: GTD has extended to other distant sites, called metastasis.
How long is the treatment for choriocarcinoma?
Treatment for choriocarcinoma usually takes 4-5 months to complete and the cure rate is over 95%.
How quickly does choriocarcinoma spread?
Choriocarcinoma can develop some months or even years after pregnancy and can be difficult to diagnose, because it is so unexpected. They can grow quickly and might cause symptoms within a short period of time. They can spread to other parts of the body but are very likely to be cured by chemotherapy treatment.
What are the stages of choriocarcinoma?
Stage I: Disease is only in the uterus. Stage II: GTD extends outside the uterus but is limited to the genital structures. Stage III: GTD extends to the lungs and may or may not involve the genital tract. Stage IV: GTD has extended to other distant sites, called metastasis.
Is choriocarcinoma benign or malignant?
A choriocarcinoma is a malignant tumor that forms from trophoblast cells and spreads to the muscle layer of the uterus and nearby blood vessels.
What Causes Choriocarcinoma?
The development of choriocarcinoma is preceded by other pregnancy related conditions such as hydatidiform mole, which constitutes 50% of all cases....
What Symptoms Present in Choriocarcinoma?
Manifestations of choriocarcinoma include: 1. Increased HCG (human chorionic gonadotropin) levels beyond the first trimester and excessively increa...
Staging of Choriocarcinoma
Staging of choriocarcinoma follows the FIGO staging system of uterine cancer. Different stages are described as: 1. Stage I – Stage I choriocarcino...
How Choriocarcinoma Diagnosed?
Diagnostic tests are done to detect trophoblastic malignancy. These include: 1. Pregnancy Test – The elevation of HCG in the blood and urine can be...
Why is choriocarcinoma caused by grape-like structures?
The grape-like structures grow and should be removed because it does not cause viable pregnancy and may form malignant cells.
How long does it take for choriocarcinoma to reoccur?
Some choriocarcinoma may also reoccur after months up to 3 years of treatment.
What causes choriocarcinoma in pregnancy?
The development of choriocarcinoma is preceded by other pregnancy related conditions such as hydatidiform mole, which constitutes 50% of all cases. Spontaneous abortion and ectopic pregnancy also results to 20% and 2% of the cases respectively. Normal term pregnancy may also result to 20 to 30% of choriocarcinoma. The malignant cells usually grow following a normal pregnancy. Genital tumors may also lead to choriocarcinoma. Hydatidifporm mole, the leading cause of choriocarcinoma is the development of grape-like structure that should have normally formed the embryo. The grape-like structures grow and should be removed because it does not cause viable pregnancy and may form malignant cells.
What is stage IV cancer?
Stage IV – Stage IV involves metastases of cancer cells to other parts of the body through hematogenous and lymphatic routes.
Why do they do chest x-rays?
X-rays – Chest X-rays are also done to determine lung metastases because choriocarcinoma is very aggressive in spreading to the lungs.
What is the staging system for choriocarcinoma?
Staging of choriocarcinoma follows the FIGO staging system of uterine cancer. Different stages are described as:
Is choriocarcinoma a malignancy?
Choriocarcinoma is uncommon, but a highly curable malignancy associated in pregnancy. Because of the problems in the placenta, a fetus may or may not develop. It may also be called as trophoblastic tumor, chorioblastoma, chorioepithelioma or gestational trophoblastic neoplasia.
Where does choriocarcinoma occur?
Choriocarcinoma is a malignant tumour. It mostly occurs in the placenta of pregnant women. The cancerous cells first develop in the tissue of a developing placenta. However, in some rare cases, it forms in men’s testicles and in the uterus of the affected post-menopausal woman.
How rare is choriocarcinoma?
Choriocarcinoma is relatively rare with an incidence of one case per 40,000 pregnancies and for it to occur during pregnancy is even rarer. Studies suggest that about one in every 40,000 pregnant women and one in 40 patients with hydatidiform moles are likely to develop the disease in America and Europe. The number increases in Southeast Asia and Japan; about 9 in 40,000 pregnancies, and 3 in 40 patients with hydatidiform moles are likely to develop it in these regions. And, one in every 2800 pregnancies in China are likely to be affected by it.
What is radiation treatment?
Radiation treatment is for people who are at high risk. It is given at a time when the cancer cells have spread to other parts of the body.
What happens if you have cancer in your lungs?
If in case the cancer cells have spread to the lungs, then the person may experience shortness of breath, chest pain, and may cough up blood.
Is choriocarcinoma a malignant tumor?
Choriocarcinoma is a rare and rapidly growing malignant cancer that occurs in the uterus after a molar pregnancy. It falls into the category of gestational trophoblastic disease. It can arise in women who have had a miscarriage, or an ectopic pregnancy. It can also occur in normal pregnancies. However, a hydatidiform mole is the main cause of the disease. Read on to know more about choriocarcinoma.
Can choriocarcinoma be cured?
Choriocarcinoma is usually treated with chemotherapy. In case the tumour is chemoresistant, i.e. it cannot be cured by chemotherapy, then the womb is removed to get rid of the disease.
Can choriocarcinoma be caused by a molar pregnancy?
Choriocarcinoma after a normal pregnancy may occur, but it is more prevalent during molar pregnancy. The disease comes into being when big lumps called hydatidiform moles are formed in the uterine tissue at the beginning of a pregnancy. These moles then become cancerous, and the cells start multiplying. Then they start spreading out.
Which hormone is responsible for choriocarcinoma?
As published, choriocarcinoma is totally driven by the TGFβ antagonist and autocrine hyperglycosylated hCG [25,34]. As described in Chapter 22, through this mechanism hyperglycosylated hCG drives choriocarcinoma cell growth, blockage of apoptosis, and production of invasive enzymes, collagenases, and metalloproteinases [25,35,36].
Where does choriocarcinoma occur?
Choriocarcinoma is a gestational trophoblastic tumor in most cases arising in the uterus, although ectopic pregnancies provide extra-uterine sites of origin. Histologically, it is differentiated from other gestational trophoblastic tumors by the absence of chorionic villi, although it is composed of sheets of both anaplastic cyto- and syncytiotrophoblasts, which are cells types of the early embryo and gestational sac. Choriocarcinoma may also rarely occur in primary locations other than the placenta; very rarely, it occurs in testicles. Pure choriocarcinoma of the testis represents the most aggressive pathologic variant of germ cell tumors in adults, characteristically with early hematogenous and lymphatic metastatic spread. Because of early spread and inherent resistance to anticancer drugs, patients have poor prognosis. Choriocarcinomas can also occur in the ovaries.
What type of cells are choriocarcinoma cells?
Cells called choriocarcinoma cells predominantly comprise cytotrophoblast cells . To a lesser extent, they contain fused syncytiotrophoblast cells [28,30]. Just like the cytotrophoblast cells of implantation, they primarily produce hyperglycosylated hCG. Research shows that choriocarcinoma cells are (similar to implantation cells) driven to grow and invade solely by hyperglycosylated hCG functioning through the TGFβ receptor [30,47]. In this respect they are similar to implantation cells.
How rare is choriocarcinoma?
Gestational choriocarcinoma is quite rare, occurring in only 1 in 24 000–40 000 pregnancies. It is increased in mothers over 40 years of age, and a prior hydatidiform mole confers a 1–2000-fold risk. Choriocarcinoma is one of the most hemorrhagic tumors in the human body.
What is the rarest cancer that can be found in placental tissue?
Choriocarcinoma. Choriocarcinoma is a rare cancer forming from placental tissues, which may occur after miscarriage, abortion, ectopic pregnancy, or term pregnancy. From: Handbook of Clinical Neurology, 2020. Download as PDF.
How many pregnancies are there with choriocarcinoma?
Choriocarcinoma occurs after pregnancy in 1 in 30,000 pregnancies in the United States [33]. Choriocarcinoma also occurs after complete hydatidiform mole. Complete hydatidiform mole occurs in 1 in 900 pregnancies in the United States. It affects approximately 1 in 50 complete hydatidiform mole cases [33].
Where is intraplacental choriocarcinoma seen?
Figure 17. Intraplacental choriocarcinoma (right) is seen within normal placental tissue (left). There is trophoblastic proliferation around a fibrovascular structure on the right, as opposed to the normal chorionic villi on the left.
Choriocarcinoma Symptoms
Symptoms of Choriocarcinoma commonly depend on the type of the body part affected. Abnormal vaginal bleeding is the most common sign of Choriocarcinoma which is different from menstrual bleeding. Irregular vaginal bleeding is common in women who have hydatidiform mole, abortion or pregnancy history.
Choriocarcinoma Treatment
Treatment of Choriocarcinoma depends on age of patient, nature, the stage of the disease at the time it is diagnosed and spread of cancer to other parts of the body. Chemotherapy with surgery is the main type of treatment for Choriocarcinoma.
Choriocarcinoma Prognosis and Life Expectancy
Metastatic Choriocarcinoma prognosis and life expectancy was once grim. But at the present with the advent of multidrug chemotherapy it has noticeably improved. The prognosis of Choriocarcinoma patient depends on the stage at which the condition is diagnosed.
What is a choriocarcinoma?
Choriocarcinoma is one type of gestational trophoblastic disease (GTD). GTD is a condition that starts from the trophoblastic cells, which help an embryo (a fertilized egg) attach to the uterine wall. In a healthy pregnancy, these cells eventually become the placenta. But abnormal cells in the tissues of the uterine wall can form a tumor. 2
Can cancer spread to other parts of the body?
It is possible to have other symptoms, especially if the cancer spreads to other parts of the body. If it spreads to the brain, it can cause neurological problems. If it spreads to the chest area, it can affect breathing. 4
Is choriocarcinoma rare?
Choriocarcinoma is very rare, so it is unlikely that your symptoms will turn out to be this cancer. Still, having symptoms can be stressful, especially if you are pregnant. It is important to get regular prenatal care and not miss any appointments. If you do receive a diagnosis, your physicians, oncology team, and other healthcare providers will work together to help you create a treatment plan.
Can choriocarcinoma spread to other organs?
Choriocarcinoma can also spread through your blood to reach other organs, such as the lungs, and cause additional complications.
Can a person with a uterus get choriocarcinoma?
People who have a uterus can get choriocarcinoma. Most choriocarcinomas start in the uterus after sperm fertilizes an egg. They usually affect someone who: 4
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Can choriocarcinoma cause complications?
It is possible to have complications because of choriocarcinoma. They can include: 3