Choriocarcinoma in Mother and Infant

Unexplained anaemia and failure to thrive as initial symptoms of infantile choriocarcinoma: a review

“…Surgery [2,9,19,24,36] or single agent chemotherapy [1,3,10,22] alone (methotrexate monotherapy [3,10], doxorubicin plus dexamethasone [1,22]) did not alter the prognosis. Seven infants received combined modality treatment including a platinum-containing chemotherapy [5,6,14,15,16,32,33], in five of these patients a sustained remission was achieved by combining multiagent chemotherapy with delayed (4/5) [6,14,15,33] or primary tumour resection (1/5) [5].…”

“…This may lead to haematogenous metastases in the mother and/or offspring resulting in early infantile death. To the authors' knowledge, 30 different neonates and infants including two stillbirths affected by the disease have been reported in the literature [1,2,3,5,6,7,8,9,10,11,12,13,14,15,16,18,19,20,21,22,23,24,25,26,27,29,30,32,33,35,36]. The prognosis of affected children may be improved by early diagnosis and institution of the appropriate treatment, as demonstrated in five infants [5,6,14,15,33].…”

“…Of the 29 women on whom information is given, 17 (59%) developed maternal choriocarcinoma [1,2,3,7,10,13,14,15,18,23,24,25,27,29,30,35,36] (Table 2). A fatal outcome was reported in 3/17 women [2,10,24], for one affected woman a partial response and no further information on the final outcome was reported [3], for one affected mother no information was given on treatment and outcome [36]; thus in 15 mothers affected by maternal choriocarcinoma, detailed information on maternal follow-up is available and 12 of these 15 women (80%) achieved a complete remission.…”

“…A fatal outcome was reported in 3/17 women [2,10,24], for one affected woman a partial response and no further information on the final outcome was reported [3], for one affected mother no information was given on treatment and outcome [36]; thus in 15 mothers affected by maternal choriocarcinoma, detailed information on maternal follow-up is available and 12 of these 15 women (80%) achieved a complete remission. One woman had a history of a previous successfully treated choriocarcinoma [15], two women had a previous history of a hydatiform mole [1,30].…”

“…The literature indicates that a delayed resection of a necrotic tumour after chemotherapeutic pretreatment is safer than an attempted primary resection of a highly vascularised friable tumour [2,9,19,36]. Surgery alone [2,9,19,24,36] had a fatal outcome. Methotrexate monotherapy [3,10], as proven useful in gestational trophoblastic disease of the mother, did not result in a sustained remission in affected infants.…”