It is a gestational trophoblastic disease (GTD for its acronym in English).
What is it? It is a rare type of tumor that most often affects pregnant women, called Gestational Choriocarcinoma.
Choriocarcinoma is the most aggressive form of ETG (gestational trophoblastic disease) due to its rapid growth and metastatic potential.
They usually develop after a CM (Medical classification or medical coding); It has been reported that the incidence in patients with a history of CM is 29-83%, according to various studies throughout the world.
Partial moles and PSTT (placental bed trophoblastic tumor) rarely lead to choriocarcinoma. Choriocarcinomas can occur after any pregnancy, usually in the first year, although there have been cases of choriocarcinoma after 35 years after pregnancy.
The incidence of choriocarcinoma after term labor with no history of CM is approximately 1: 50,000. The true incidence may be much higher, but curiously, choriocarcinoma after a full-term pregnancy is more often associated with aggressive disease.
Patients present symptoms similar to those of the hydatidiform moles, but gynecological symptoms may be absent in up to a third of the cases in those with metastases. The disease can metastasize to any place: lungs, brain, liver, skin, heart, etc.
– Brain metastases present with seizures, focal neurological signs, intracerebral bleeding, or signs of elevated intracranial pressure.
– Liver metastases may cause local pain or referred pain in the tip of the right shoulder.
Although these symptoms or characteristics are not exclusive to ETG, it is an important differential diagnosis that should be considered in women of childbearing age who have metastases of unknown primary origin, which can be quickly confirmed by serum hCG and tumor biopsy.
The high hCG level can also cause thyrotoxicosis and ovarian lute teak cysts.
What causes it?
Choriocarcinoma is formed when the cells part of the placenta in a normal pregnancy become cancerous. It can occur after spontaneous abortion, abortion, ectopic pregnancy, or molar pregnancy, when an egg is fertilized, but the placenta develops into a mass of cysts instead of a fetus.
What are the symptoms?
If the choriocarcinoma is in the vagina, it could cause bleeding. If it has spread to the abdomen, you may also feel pain or pressure. If it has spread to other parts of your body, such as the lungs or the brain, you can see:
- Difficulty breathing
- Chest pain
How is it diagnosed?
If the doctor thinks he has choriocarcinoma, he will do some tests on the patient:
- A pelvic exam to detect unusual lumps or changes
- A test to look for levels of a hormone called hCG. These will be high if you have an ETG.
- Blood and urine tests
- An exam to see if cancer has spread to other parts of your body
- Imaging tests such as CT, MRI, ultrasound, or X-ray
It usually arises in association with the reproductive organs:
The primary occurrence outside the reproductive system has been reported but is extremely rare. These sites include:
- Pulmonary arteries
- Small intestine
Which is the treatment?
The doctor will discover the status of choriocarcinoma. He will give the patient a score based on a test to determine how giant the tumor is and if it has spread to other parts of the body, among other things. If the cancer is low risk, which means it is small and has not spread, chemotherapy is the primary treatment.
You will have to undergo it until there are no signs of cancer in the body, depending on hCG levels. If the tumor is a high risk, surgery, chemotherapy, or surgery, chemotherapy and radiation may be needed.
Almost all women diagnosed with the disease are cured with the treatment, although it is less likely if the disease has spread to your liver or your liver and brain. But each case is different, and your doctor will discuss the right option for you.