malignancy that arises from placental trophoblastic tissue and is aggressive in nature
| Risk factors | • Advanced maternal age • Prior complete hydatidiform mole | | --- | --- | | Presentation <6 months after a pregnancy | • Amenorrhea or abnormal uterine bleeding • Pelvic pain/pressure • Symptoms from metastases (lung, vagina) • Uterine mass | | Diagnostics | • Elevated β-hCG level helps confirm Dx upon suspicion • CXR→ multiple bilateral infiltrates of various shapes is consistent with metastasis | | Treatment | • Chemotherapy |
most commonly follows a hydatidiform mole, choriocarcinoma can occur after a normal gestation or spontaneous abortion.
most common site of metastatic spread is to the lungs causing symptoms of lung mets including chest pain and hemoptysis and dyspnea
The vagina is a common site of metastasis, presenting as a friable mass.
The staging system for choriocarcinoma relies on chest x-ray, rather than chest CT scan, findings. Even among patients with choriocarcinoma who have a negative chest x-ray, the detection of metastasis on chest CT scan is not associated with worsened outcomes and does not alter management.