The tumour typically occurs in women of childbearing age as a gestational choriocarcinoma. Most such cases present within one year of an antecedent pregnancy 2. Presentation beyond reproductive age as a non-gestational choriocarcinoma is a rare occurrence 2-3.
As with choriocarcinomas in general, it is a highly vascular neoplasm. The tumour comprises of trophoblastic cells. On histology, there is an absence of chorionic villi (c.f. other forms of GTD).
In the case of gestational choriocarcinoma, approximately 5% of cases of complete hydatidiform mole are followed by choriocarcinoma.
Only about half the cases of choriocarcinoma arise from complete hydatidiform mole. An additional 25% of cases arise after normal pregnancies, and 25% follow spontaneous abortion or ectopic pregnancy.
Regardless of the imaging modality used, choriocarcinoma often appears as a mass enlarging the uterus. Sometimes it manifests as a discrete, central, infiltrative mass. Its heterogeneous appearance correlates with necrosis and haemorrhage that characterise these lesions.
They can have a variable sonographic appearance.
Treatment and prognosis
Those cases that arise after complete hydatidiform mole are nearly all cured by chemotherapy (in contrast to the others, which have a less favourable prognosis).
- 1. Hönigl W, Reich O, Ranner G et-al. [Choriocarcinoma of the uterus after term pregnancy: imaging by vaginal color Doppler ultrasound]. Ultraschall Med. 1997;18 (4): 165-8. doi:10.1055/s-2007-1000418 - Pubmed citation
- 2. Desai NR, Gupta S, Said R et-al. Choriocarcinoma in a 73-year-old woman: a case report and review of the literature. J Med Case Reports. 2010;4 : 379. doi:10.1186/1752-1947-4-379 - Free text at pubmed - Pubmed citation
- 3. Diouf A, Cissé ML, Laïco A et-al. [Sonographic features of gestational choriocarcinoma]. J Radiol. 2005;86 (5 Pt 1): 469-73. - Pubmed citation