The cutup of orchiectomy specimens is dealt with in orchiectomy grossing. We report a surgically treated case of choriocarcinoma in a 37yearold woman who came to our. This is the organ that develops during pregnancy to feed the fetus. Choriocarcinoma is pathology confirmed malignancy of the trophoblast cell of the placenta.
When it occurs in the absence of preceding gestation, it is termed nongestational choriocarcinoma these occur most often in the ovary or testis. Apr 17, 2003 choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. Manual of pathology of the human placenta, second edition is a concise, practical manual of placental pathology. The prognosis of primary mediastinal choriocarcinoma is still very poor despite the introduction of combination chemotheraphy including cisplatin. Pdf case study of choriocarcinoma following a term pregnancy. We use your linkedin profile and activity data to personalize ads and to show you more relevant ads. Dna patterns from tumor and maternal tissue, as well as villous tissue from any available prior or concurrent gestation, were compared, to determine gestational versus nongestational nature containing vs. Imaging features of a primary tumor are dependent on location. Surgical pathology dissection an illustrated guide second edition william h. On histology, there is an absence of chorionic villi c.
The text throughout is current and thoroughly referenced. Choriocarcinoma is a malignancy of placental origin. In the case of gestational choriocarcinoma, approximately 5% of cases of complete hydatidiform mole are followed by choriocarcinoma. Choriocarcinoma is a rare cancer that occurs as an abnormal pregnancy. May present initially with metastases liver, lung, mediastinum, retroperitoneum with normal testis or small tumor but with increased serum hcg. Choriocarcinoma is one of the tumors that are very responsive to chemotherapy, except for the case of choriocarcinoma in the testicles. Choriocarcinoma is pathologyconfirmed malignancy of the trophoblast cell of the placenta. Untreated choriocarcinoma characteristically presents with early hematogenous metastases. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency medicine, endocrinology and diabetes, family medicine, gastroenterology and hepatology, hematology, infectious diseases, nephrology and. Choriocarcinoma symptoms,causes,diagnosis and treatment. Early hematogenous spread to lungs, liver and brain. Commonly, symptoms or test results can indicate choriocarcinoma. Choriocarcinoma definition a choriocarcinoma is type of cancer germ cell containing trophoblast cells.
Description choriocarcinomas are cancers that develop from germ cells, cells that ordinarily turn into sperm or eggs. Gestational choriocarcinoma is a malignant trophoblastic tumour arising from any gestational event during pregnancy in the reproductive female. The testis, plural testes, are important for survival of the species. Patients with no metastases have a high recovery rate. Media in category choriocarcinoma this category contains only the following file. It is a malignancy of placental origin in which the trophoblastic cells of the uterus undergo malignant alteration that causes improper progress of the. Choriocarcinoma symptoms, prognosis, treatment, diagnosis. However, when metastases are already present in the brain and liver, the condition is usually fatal. In this volume dr hui has brought together a comprehensive overview of gestational trophoblastic disease that includes all the currently recognized entities. Testicular choriocarcinoma is one of the histologic types of nonseminomatous germ cell tumors nsgcts, which along with testicular seminoma constitute the two major histologic groups of testicular cancers. Choriocarcinoma transactions of a conference of the.
Choriocarcinoma is one of the causes of cannonball metastases to the lungs. Choriocarcinoma is an aggressive neoplasm arising in the body of the uterus. General pathology covers the basic mechanisms of diseases whereas systemic pathology covers diseases as they occur in each organ system. Distinction of these subtypes has prognostic and therapeutic implications. Help support this site, yourself, or your loved one visit the bookstore to purchase print or digital copies of the my molar pregnancy book collections, which contain dozens of womens experiences with molar pregnancy or choriocarcinoma from diagnosis to recovery. In situ or intraplacental choriocarcinoma has been well documented to occur in fullterm placentas. Choriocarcinoma online pathology video lecturio online. Sep 29, 2011 choriocarcinoma is a complicated condition that can create problems in pregnancy and even lead to lifethreatening disorders. Most patients develop gestational choriocarcinoma shortly after gestational. Department of pathology department of pathology the johns hopkins university the johns hopkins university school of medicine school of medicine baltimore, maryland baltimore, maryland timothy h.
Syncytiotrophoblasts, large eosinophilic smudgy multinucleated cells with known, large hyperchromatic nuclei, are intermixed. Choriocarcinoma is a fastgrowing cancer that occurs in a womans uterus womb. Choriocarcinoma transactions of a conference of the international union against cancer. On gross examination, a circumscribed hemorrhagic mass is observed. Medics told the shocked couple that tammie, 29, had choriocarcinoma, a type of persistent trophoblastic, very rare pregnancyrelated tumour. In 1977 8, it was observed that using a combination of gross, histologic and.
Testicular tumors are the most common malignancies among american men between the ages of 20 and 39 years. Choriocarcinoma most often follows a molar pregnancy but may. While references are made to the more encyclopedic pathology of the human placenta, this manual is designed as a userfriendly, easytoread bench manual that can be used in the grossing room as well as at the microscope. General pathology lecture notes for health science students. A case of malignant trophoblastic disease with brain metastasis, raised intra cranial pressure and small bowel metastasis presenting. Such cases are called gestational trophoblastic neoplasm until pathology is confirmed. The prognosis of this tumor is extremely poor, despite surgical and chemotherapeutic treatment. Gross pathology of avian diseases top results of your surfing gross pathology of avian diseases start download portable document format pdf and e books electronic books free online rating news 20162017 is books that can provide inspiration, insight, knowledge to the reader. The extensive necrosis, vascular penetration, and hemorrhage are evident from this specimen.
An overview of testicular germ cell tumors archives of. Gestational trophoblastic tumors archives of pathology. Pure choriocarcinoma of the testis is rare, accounting for only 0. Download fulltext pdf download fulltext pdf case study of choriocarcinoma following a term pregnancy article pdf available in acta medica mediterranea 32. Dr hui is a boardcertified surgical pathologist with clinical specialty areas including gynecologic pathology and molecular diagnostics. As with choriocarcinomas in general, it is a highly vascular neoplasm. We describe an unusual case of metastatic choriocarcinoma of the pancreas arising from a regressing testicular mixed germ cell tumor that clinically mimicked a primary pancreatic tumor. Choriocarcinoma symptoms, treatment, prognosis choriocarcinoma is a category of gestational trophoblastic disease which is quickgrowing form of cancer that occurs in a womans uterus womb. Choriocarcinoma is a complicated condition that can create problems in pregnancy and even lead to lifethreatening disorders. An unusual case of primary choriocarcinoma of the lung bmc. Elevation may be seen in other nontrophoblastic tumours. Primary mediastinal choriocarcinoma is characteristically seen in young caucasian men presenting with the symptom triad of cough, gynecornastia and chest pain.
High hcg levels greater than 100,000 miuml prognostic factors. Choriocarcinoma is a type of gestational trophoblastic disease. Free pathology books download ebooks online textbooks. It is also classified as a germ cell tumor and may arise in the testis or ovary. Choriocarcinoma is defined by the presence of syncytiotrophoblast cells. Epidemiology, clinical features, gross features, and histopathology have. Part of the uicc monograph series book series uicc, volume 3 log in to. Microscopic view of choriocarcinoma taken from the uterus illustrated in figure 9. Choriocarcinoma is a rare type of tumor that happens in women during pregnancy. Sheets of anaplastic trophoblastic cells are noted without the maintenance of the pattern of the villi. This book is intended to be a textbook of general pathology for health science students.
This book will be of great value to pathologists, community gynecologists, gynecological pathologists and medical students. Pathology characteristic feature is the identification of intimately related syncytiotrophoblasts and cytotrophoblasts without formation of definite placental type villi. We herby report a case of primary mediastinal pure. Unusual presentation of choriocarcinoma world journal of. The cancer may also occur after a normal pregnancy. Gestational choriocarcinoma follows normal pregnancy 25%, spontaneous abortion 25%, and hydatidiform mole 50%, but only about 35% of all molar pregnancies eventuate in choriocarcinoma. The final chapter covers clinical aspects of gestational trophoblastic disease, including treatment. Case report successful treatment of choriocarcinoma with. Malignant trophoblastic tumor comprising a trimorphic proliferation of syncytiotrophoblast, cytotrophoblast and intermediate trophoblast with. Choriocarcinoma article about choriocarcinoma by the.
Primary choriocarcinoma of the lung is extremely uncommon. Choriocarcinoma is a malignant, trophoblastic cancer, usually of the placenta. Currently, he is director of gynecologic pathology service, clinical. He joined the pathology faculty at yale university, new haven, connecticut, in 2001 and became full professor in 20. Malignant transformation in a hydatidiform mole is rare event. There is no difference in pathological appearances between gestational type and nongestational pure choriocarcinoma. Nov 15, 2004 we describe an unusual case of metastatic choriocarcinoma of the pancreas arising from a regressing testicular mixed germ cell tumor that clinically mimicked a primary pancreatic tumor. A baby may or may not develop in this type of pregnancy.
The reasons that normal chorionic cells undergo cancerous change, with exaggeration of their natural and potent tendency to invade the uterine muscle and break down blood vessels, are unknown. A study of choriocarcinoma its incidence in india and its aetiopathogenesis. Primary nongestational pure choriocarcinoma arising in the ovary. Pure choriocarcinoma of the testis is the exception to most of the rules established for testicular seminoma and all other forms of nsgcts. Below are 200 highyield general pathology points which serve as a quick revision for memorizing important general pathology concepts from exam point of view. Microscopically, hemorrheage and necrosis are found, and tumor cells resemble placental trophoblastic cells. Sep 07, 2019 testicular choriocarcinoma is one of the histologic types of nonseminomatous germ cell tumors nsgcts, which along with testicular seminoma constitute the two major histologic groups of testicular cancers. Common metastatic sites include lung, brain, liver, kidney and bowel.
Highyield general pathology notes for usmle step 1fcps part 1. Part of the uicc monograph series book series uicc, volume 3 log in to check access. Since choriocarcinomas include syncytiotrophoblasts betahcg producing cells, they cause elevated blood levels of betahuman chorionic gonadotropin. Patients with mediastinal choriocarcinoma are mostly young men. Twentytwo tumors were genotyped using polymerase chain reaction amplification of 15 short tandem repeat loci and the amelogenin locus xy determination.
Upon gross inspection, the mass predominantly consisted of. It is more common in women, but may also affect men. It belongs to the malignant end of the spectrum in gestational trophoblastic disease gtd. Gestational primary ovarian choriocarcinoma is extremely rare, with an estimated incidence of 1 in 3. Choriocarcinoma starts as a gestational trophoblastic disease and progresses to a malignancy. Pure nongestational choriocarcinoma is a primary germ cell neoplasm. An unusual case of primary choriocarcinoma of the lung. This is a growth that forms inside the womb at the beginning of a pregnancy. We report a surgically treated case of choriocarcinoma in a 37yearold woman who came to our attention because of a isolated lung. Grossly, choriocarcinoma is a soft, friable tumor with extensive. Women with gestational choriocarcinoma may present with abnormal vaginal bleeding, persistent markedly elevated. The diagnosis of diseases of women 1905 14760098631.
Choriocarcinoma is an uncommon malignant neoplasm, which can be either gestational or nongestational in origin. Choriocarcinomas resemble the cells that surround an embryo in the uterus. Manual of pathology of the human placenta springerlink. After treatment with chemo, you can still get pregnant again. On gross examination the resected small intestine measured 14 cm in length.
It is characterized by early hematogenous spread to the lungs. When it is associated with gestation, it is often considered part of the spectrum of gestational trophoblastic disease. Uterine choriocarcinoma radiology reference article. Metastasis may be clinically solitary and may occur in unusual locations and often present with massive hemorrhage. But it most often occurs with a complete hydatidiform mole. Highyield general pathology notes for usmle step 1fcps. Fetus is rarely involved, even in cases of widespread metastatic disease. Read and know all about this disease including its causes, symptoms, diagnosis and treatment.
Choriocarcinomas resemble the cells that surround an. Choriocarcinoma is an aggressive, highly vascular tumor. The abnormal cells start in the tissue that would normally become the placenta. Gestational trophoblastic disease diagnostic and molecular. Sir, primary choriocarcinoma of the mediastinum occurs in both sexes, but is extremely rare.
Choriocarcinoma is a germ cell tumor containing syncytiotrophoblastic cells and secreting human betahcg. Median in one series of testicular choriocarcinoma 200,000 iu. Ebook gross pathology of avian diseases as pdf download. Choriocarcinoma is defined by the presence of syncytiotrophoblast cells intimately admixed with cytotrophoblast cells. Description of textbook of pathology, this is the 7th edition of textbook of pathology by harsh mohan, i look back with satisfaction how this book has grown phenomenally since its modest beginning in 1992. If the testis is biopsied, it is usually for fertility.