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Since gestational choriocarcinoma (which arises from a hydatidiform mole) contains paternal DNA (and thus paternal antigens), it is exquisitely sensitive to chemotherapy. The cure rate, even for metastatic gestational choriocarcinoma, is more than 90% when using chemotherapy for invasive mole and choriocarcinoma. [7]
Gestational choriocarcinoma is a form of gestational trophoblastic neoplasia, which is a type of gestational trophoblastic disease (GTD), that can occur during pregnancy. It is a rare disease where the trophoblast , a layer of cells surrounding the blastocyst , undergoes abnormal developments, leading to trophoblastic tumors .
Although choriocarcinoma is a highly malignant tumour and a life-threatening disease, it is very sensitive to chemotherapy. Virtually all women with non-metastatic disease are cured and retain their fertility; the prognosis is also very good for those with metastatic (spreading) cancer, in the early stages, but fertility may be lost.
Cannonball metastases are classically seen in renal cell carcinoma, [5] also seen in choriocarcinoma, endometrial cancer, [6] prostate cancer and some gastrointestinal malignancies. The presence of cannonball metastases is a hallmark of advanced systemic malignancy. Identification of these lesions often triggers search for primary tumor.
In 2 to 3% of cases, hydatidiform moles may develop into choriocarcinoma, which is a malignant, rapidly growing, and metastatic (spreading) form of cancer. Despite these factors which normally indicate a poor prognosis, the rate of cure after treatment with chemotherapy is high.
The exact pathogenesis of choriocarcinoma has not been fully understood, but studies have shown cytotrophoblast cells function as stem cells and transform into malignant form. The neoplastic cytotrophoblast further differentiates into either intermediate trophoblasts or syncytiotrophoblast. [citation needed]
A micrograph showing a choriocarcinoma spread to the lung [13] Choriocarcinomas are exceptionally rare which account for 2.1%-3.4% of all OGCTs. [ 14 ] Under gross examination, the syncytiotrophoblast cells are aligned in a plexiform arrangement with the mononucleated cytotrophoblast cells surrounding the foci of the hemorrhage. [ 1 ]
Teratocarcinoma refers to a germ cell tumor that is a mixture of teratoma with embryonal carcinoma, or with choriocarcinoma, or with both. [9] This kind of mixed germ cell tumor may be known simply as a teratoma with elements of embryonal carcinoma or choriocarcinoma, or simply by ignoring the teratoma component and referring only to its ...