Choriocarcinoma is cancer of the placenta. This disease is also referred to as Chorio Cancer and molar pregnancy. This cancer is malignant and aggressive cancer, which is spread via blood (hematogenous) usually to the lungs. This cancer is at the far end of a spectrum of diseases known as Gestational Trophoblastic Diseases (GTD). Gestational Trophoblastic disease is a group of diseases that involve atypical malignant cell growth in the uterus. It is not cervical or endometrial cancer, but formed from the cells which develop after conception of the sperm and egg. These cancers are rare and were once fatal, but now have a high cure rate. The spectrum of diseases is classified as Hydatidiform Mole, Invasive Mole, and choriocarcinoma. Hydatidiform Mole is broken down into two subtypes, a complete Mole and a partial Mole. Choriocarcinoma is broken down as limited to the uterus and metastic (or spread to other parts of the body).
Symptoms of Choriocarcinoma are vaginal bleeding, shortness of breath, hemoptysis or coughing up blood, and chest pain. Blood work will indicate high levels of β-hCG. A chest X-ray will display various shapes in both lungs of many infiltrates.
Choriocarcinoma begins with a pregnancy in which development goes haywire and the cells become malignant.
The preceding conditions and their rate of becoming choriocarcinoma are:
Abortion or removal of etopic pregnancy precedes 20% of all Choriocarcinoma cases
Hydatidiform mole precedes 50% of Choriocarcinoma cases
Normal term pregnancy precedes 20-30% of Choriocarcinoma cases.
Early markers of this disease are difficult to notice because some symptoms appear in a typical pregnancy. Symptoms that are not typical are excessive vaginal bleeding, abnormal discharge, rapidly growing abdomen, swelling or pain in the abdomen and sometimes severe vomiting.
A pelvic exam will determine if there are any oddly shaped lumps in the uterus or the uterus is unusually large. An ultrasound or CT scan will detect tumors. The hormone, beta human chorionic gonadotropin is typically present in the blood and urine during pregnancy. Higher levels of this hormone in the urine or blood indicate the individual may have choriocarcinoma.
Choriocarcinoma has been detected in males, who have probably had the cancerous cells or precancerous cells in their system from birth. A woman who is not pregnant, but has beta hCG in her blood stream possible has gestational trophoblastic disease.
Most patients do very well and require no extensive treatment other than the removal of the cancerous cells. In more severe cases, thought rare, a hysterectomy and chemotherapy may be needed.
Choriocarcinoma is very sensitve to chemotherapy. Metastatic choriocarcinoma has a cure rate of up to 95% with chemotherapy. Almost all patients with no metastases of choriocarcinoma are cured. The chemotherapy regimen for this disease is a cocktail of drugs consisting of etoposide, methotrexate, actinomycin D, cyclosphospharmide and oncovin (EMACO).
Hysterectomy may be required if the bleeding is uncontrollable or a dangerous infection is present.
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