Gestational choriocarcinoma

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Gestational choriocarcinoma is a malignant trophoblastic tumour arising from any gestational event during pregnancy in the reproductive female. Patients may present with abnormal vaginal bleeding, persistent markedly elevated βhCG, or a history of prior pregnancy. Most patients develop gestational choriocarcinoma shortly after gestational anomalies, but pathology may occur after a long latency of years.

Grossly, a red hemorrhagic mass is seen in the uterus, though it may vary in size. Often, diagnosis is presumptive, and based on clinical findings and the identification of a malignant trophoblast.

Outcome

At the time of diagnosis, more than 90% of patients already have lung metasteses, though there are also less frequent metasteses to the brain and liver. With chemotherapy, patients have an 80% 5-year survival rate. Ultimately, death is related to liver and brain metasteses.

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