Choriocarcinoma with Intact Pregnancy Report of a Case with Review of the Literature

Steigrad, Stephen J.; James, R. W.; Osborn, R A

doi:10.1111/j.1479-828x.1968.tb00687.x

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…Fox and Laurini [10] have suggested not only that choriocarcinoma in normal pregnancy more likely follows intraplacental choriocarcinoma than arises from retained trophoblastic tissue in the uterus but also that postmolar choriocarcinoma may result from intramolar choriocarcinoma. This theory is supported by documented cases of intraplacental choriocarcinoma [1,5,7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Unfortunately, most maternal choriocarcinoma following otherwise normal pregnancy is not diagnosed until such an interval after delivery has passed that the placenta is no longer available for detailed review; this is compounded by the fact that even in those cases in which the placentas are examined, the lesion may not be grossly apparent [9].…”

Section: Introductionmentioning

confidence: 82%

“…Most of these have been associated with maternal metastatic disease [7,11,12,[14][15][16][17][18][19][20][21][22][23], and the diagnosis of intra- placental choriocarcinoma has led to the diagnosis of metastatic disease in an otherwise asymptomatic mother [21]. However, rare cases of intraplacental choriocarcinoma have also been diagnosed in which there was no other evidence of tumor in the mother or infant [1,10,15,24].…”

Section: Discussionmentioning

confidence: 98%

“…The lesions may also be multiple [20,21], and in one case more than 50 lesions were identified scattered throughout the placental parenchyma [21]. In cases with no gross lesions, the choriocarcinoma may prove difficult to find [12,16,17,23], requiring extensive sampling; indeed, one investigator embedded the entire placenta and then leveled blocks with suspicious areas to find the lesion [16].…”

Section: Discussionmentioning

confidence: 99%

“…Intraplacental choriocarcinoma is an uncommonly documented lesion [1,5,7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Most of these have been associated with maternal metastatic disease [7,11,12,[14][15][16][17][18][19][20][21][22][23], and the diagnosis of intra- placental choriocarcinoma has led to the diagnosis of metastatic disease in an otherwise asymptomatic mother [21].…”

Section: Discussionmentioning

confidence: 99%

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Intraplacental Choriocarcinoma Associated with Viable Pregnancy: Pathologic Features and Implications for the Mother and Infant

et al. 1998

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Choriocarcinoma arising in the placenta, or intraplacental choriocarcinoma, has seldom been reported, particularly in the absence of maternal metastases. Reluctance to diagnose choriocarcinoma in the presence of chorionic villi can delay diagnosis; however, timely diagnosis of choriocarcinoma is prognostically important, both for the mother and infant. We report the clinicopathologic findings in five mothers and infants in whom choriocarcinoma was identified in the placenta. None of the mothers had a history of gestational trophoblastic disease in previous pregnancies. Three placentas were similar with a single small lesion grossly suggesting a small infarct; microscopically these consisted of infarcted areas surrounded by choriocarcinoma. These three mothers were unusual in that none had metastatic choriocarcinoma; two were treated with chemotherapy and remained disease-free; the third was lost to follow-up shortly following delivery. The remaining two mothers had known pulmonary metastases at time of delivery. One of these latter two placentas contained a large marginal lesion microscopically identified as choriocarcinoma. The fifth placenta had rare microscopic foci of choriocarcinoma, and sheets of necrotic choriocarcinoma were identified in "blood clot" submitted with the placenta. In four of the five cases the choriocarcinoma appeared to be arising from otherwise normal chorionic villi, and in no case was there invasion of the villous stroma. All of the infants survived, and none had evidence of choriocarcinoma. These cases support the concept that choriocarcinoma associated with otherwise normal pregnancy arises in the placenta and may be more common than reported.

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Section: Introductionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intraplacental Choriocarcinoma Associated with Viable Pregnancy: Pathologic Features and Implications for the Mother and Infant

et al. 1998

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“…Choriocarcinoma with an intact pregnancy has been reported. 22 b. Extrauterine choriocarcinoma develops primarily at the place of ectopic pregnancy; there is no tumor in the uterus. c. Intraplacental choriocarcinoma is found in the placenta mainly after delivery.…”

Section: Trophoblastic Diseasesmentioning

confidence: 99%

Trophoblastic Diseases

Varga¹,

Honemeyer²,

Maeda³

2012

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Trophoblastic diseases are mainly hydatidiform mole and choriocarcinoma, where the latter is usually the sequela of molar pregnancy and malignant systemic disease with general metastases destructing various tissues and organs till she die. High level urinary hCG, real-time B-mode and color Doppler imaging detect hydatidiform mole in early gestation, postmolar persistent trophoblastic disease is diagnosed by urinary hCG, and treated by prophylactic chemotherapy against choriocarcinoma. Uterine choriocarcinoma and its metastases are diagnosed by hCG and B-mode, color and power Doppler and 3D images detecting rich tumor blood flow. Most choriocarcinoma was effectively treated by primary chemotherapy with methotrexate, etoposide, etc. Until complete remission where hCG is lower than the cut-off level. Placental site trophoblastic tumor (PSTT) and epitheloid trophoblastic tumor (ETT) were low in hCG level and high in human placental lactogen (hPL), and show rich tumor blood flow in color Doppler ultrsound. Nongestational choriocarcinoma is rare and usually chemotherapy resistant.

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Choriocarcinoma in situ at a first trimester

Fukunaga

Nomura

Ushigome

1996

Vichows Archiv A Pathol Anat

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Two cases of choriocarcinoma in situ arising in a first trimester placenta are reported in a 28-year-old gravida 2, para 1, Japanese woman and a 38-year-old gravida 2, para 0. Both had a dilation and curettage (D and C) for vaginal bleeding and the absence of intrauterine fetus. No macroscopic abnormalities were noted in either case. However, histologically, localized nodules of neoplastic trophoblastic proliferation measuring 5 mm in the first case, and 6 mm in the second appeared to arise directly from normal stem villi and project into the intervillous space. Both tumours were composed of biphasic cytotrophoblast and syncytiotrophoblast. Fetal elements were not observed in either case. Radiographic studies showed no metastatic lesions in either patient. Urinary human chorionic gonadotropin levels were within normal range in both patients. The first patient had a normal full-term spontaneous vaginal delivery 22 months after the D and C and was free from disease without therapy at 32 months. The second patient was free from disease without therapy with a limited follow-up. These tumours provide evidence for an origin of choriocarcinoma from trophoblast of a stem villus. This report illustrates the need to perform thorough microscopic examination of the products of conception especially in the absence of a fetus or fetal parts.

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Choriocarcinoma with Intact Pregnancy Report of a Case with Review of the Literature

Abstract: Summary The literature concerning choriocarcinoma in association with an intact intrauterine pregnancy is reviewed and a further case reported. A detailed study of the placenta demonstrated a site of abnormal trophoblastic proliferation.

Cited by 10 publications

References 11 publications

Intraplacental Choriocarcinoma Associated with Viable Pregnancy: Pathologic Features and Implications for the Mother and Infant

Intraplacental Choriocarcinoma Associated with Viable Pregnancy: Pathologic Features and Implications for the Mother and Infant

Trophoblastic Diseases

Choriocarcinoma in situ at a first trimester

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