CHORIOCARCINOMA

Treat ment:
- hCG monitoring
• Hysterectomy. irradiation. cytotoxic chemotherapy
• Potential ly curable by chemotherapeutic agent s
alone
• Overall survival approaches 100%
• Irradiation + chemotherapy 50% rem ission for
cerebral mets
• Irradiation to other sites usually not useful
 • •·
CHORIOCARCINOMA

Mets most frequently occurs in lungs. brain and

liver and majority of therapeutic failure have liver
and/or brain mets
Death usually results from hemorrhage or
pulmonary insufficiency
Predictor of favorable outcomes:
- 1. interval of <4 mos. since the antecedent pregnJncy
- 2. a pre-treatment hCG level of <40.000microU/ml
- 3. absence o f brain or liver mets
 CHORIOCARCINOMA

Prote an
Abnormal uterine bleeding one of the m ost
frequent presentation
Metastasis. sometimes 1• indication of
disease. lungs most frequent site
Symptomatology related to hemorrhagic
events in the CNS. liver. git or uterus
 CHORIOCARCINOMA
- consist of biphas,c proUferation of mononucfeat e
trophobbsts and syncitiotrophobLlsts without chorion,c vilh
- 1: 160.000 of normal gestation
- 1:15. 386 abom o n
- 1:5 .333 ectopic pregnancy
- 1:40 molar pregnancy:
- 50% preceded by H. mole
- 2s,5. abortion
- 22 5% normal pregnancy
- 2. 5%, ectopic pregnancy
 g

Final Anatomic Diagnosis

Ill. Intestinal Asca r iasis

IV. Theca Lutein Cysts. Bilate ral Ova ri es

An atomic La .1,e o Death : Uncal Herniation

Secondary to lntracerebra l Hemorrhage
Seconda ry to M et ast atic Ch oriocarc inoma
 •
Final Anatomic Diagnosis
I. Choriocarcinoma. Uterus. with metastasis
to:
• Right lung
• Liver
• Spleen
• Bilateral Kidneys
• Left fronto~parietal lobe, brain
II. Pulmonary Tuberculosis. Left Lung
Autopsy Findings - Liver

Gross: 1575 g
(1.200-1.700 g): Red
brown. firm and
glistening surface·
Cut section show<;
red- maroon. soft,
friable. round mass
measuring 2.5 x 1.2
x 1 cm mass at the
inferior portion of
the right lobe
Autopsy Findings - Spleen
Gross: 275 g (80
300 g); bulging 6
cm . cystic mass
and multiple red
maroon, soft
friable 1rr gularly
shaped masses
infiltrating the
splenic
parenchyma vvith
sizes ranging f ram
1 X 0.5 X 0.4 to
2.5 x 1x 0.5 cm.
Autopsy Findings - Right Kidney

Gross: 150 g
(120-180 g}; Cut
section sho\~~
red to maroon
soft . friable mass
measur,ng 2 x
17x1.Scm:
Mass 1s seen
,nhltrating the
cortex
Autopsy Findings - Uteru s

Gross· 5 x 5 x 2 cm ,
tJn bro\-v11 and
smooth: Cut sect,on
st1ows a red to
n1aroon. soft . f r,able
n1a~s mea~ur1ng 1 5
x 1.2 x 1 cm at the
antero-f undal ~1rc:1