What is Gestational Choriocarcinoma?
Gestational choriocarcinoma is a rare, malignant and rapid growing trophoblastic tumor which occurs in the uterus during pregnancy. Gestational choriocarcinoma develops from cells which should actually form the placenta, but turns into a tumor. The characteristic feature in women with gestational choriocarcinoma is abnormal vaginal bleeding with a stubbornly elevated βhCG. The patient may also have a previous history of pregnancy. Many patients develop gestational choriocarcinoma sometime after gestational anomalies; however, malignancy can develop after it remains dormant for many years. Gestational choriocarcinoma usually develops after there is some type of growth in the womb such as pregnancy, mole and tumor.
What are the Causes of Gestational Choriocarcinoma in Females?
Women who have experienced one of the following conditions tend to develop Gestational choriocarcinoma:
- Ectopic pregnancy where the pregnancy occurs anywhere excluding uterus such as in the fallopian tubes.
- After the development of a hydatidiform mole.
- After going through a normal pregnancy.
What are the Symptoms of Gestational Choriocarcinoma in Females?
The primary symptom of Gestational Choriocarcinoma is irregular vaginal bleeding after pregnancy or after the development of a hydatidiform mole. However, Gestational Choriocarcinoma can also develop after months or many years after pregnancy which makes it difficult to diagnose.
Women with Gestational Choriocarcinoma also suffer from very painful cramps or menstruation (dysmenorrhea). If the tumor has spread to other sites of the body, then the patient can also have nausea or may cough up blood.
How is Gestational Choriocarcinoma Diagnosed?
- The diagnosis of Gestational Choriocarcinoma is often presumptive and is made upon the clinical findings.
- Patient will have a positive pregnancy test even if there is no embryo/fetus, as the tumor cells produce the human chorionic gonadotrophin (hCG) hormone.
- Upon ultrasound and MRI of the pelvis, there is a red hemorrhagic mass seen in the uterus. The size of the mass can vary in size.
- The main symptom of Gestational Choriocarcinoma is vaginal bleeding after a hydatidiform mole, pregnancy or abortion.
How is Gestational Choriocarcinoma Treated?
The first line of treatment for Gestational Choriocarcinoma is chemotherapy. In some patients, a hysterectomy (surgical removal of uterus) and radiation need to be done.
What is the Prognosis & Life Expectancy of Gestational Choriocarcinoma?
When the diagnosis is made, lung metastasis is seen in more than 90% of the patients. Metastases to the brain and liver also occur, but less frequently. With treatment, patient has an 80% chance of a 5-year survival rate. Death occurs as a result of brain and liver metastases.