Choriocarcinoma is a complicated condition that can create problems in pregnancy and even lead to life-threatening disorders. Read and know all about this disease including its causes, symptoms, diagnosis and treatment.
What is Choriocarcinoma?
It is a type of malignant tumor that quickly develops in the reproductive tract of women and grows rapidly. It is mostly found in the placenta of women who are pregnant. In rare instances, however, this Choriocarcinoma can affect the testicles of men and uterus of a post-menopausal woman.
The cancerous cells develop first in the tissue that is likely to turn into the placenta, the organ that forms during the period of pregnancy to provide nutrition to the fetus.
The condition is also known by other names like:
- Gestational trophoblastic neoplasia
- Chorioblastoma
- Chorioepithelioma
- Trophoblastic tumor
It is a kind of Gestational Trophoblastic Disease.
Choriocarcinoma Symptoms
Persistent vaginal bleeding in women is the main sign of this condition. Bleeding usually occurs in pregnant women or women who have recently had abortion or a case of Hydatidiform Mole.
Some other symptoms of Choriocarcinoma include
- Ovarian Cysts (sacs located within the ovary that are filled with fluids)
- Vaginal pain
- Abnormal, localized uterine inflammation leading to a swollen abdomen
- Pain in the lower abdomen
- Irregular, heavy bleeding from the vagina
- Unusual discharge from the nipples
- Nausea or vomiting
- Non-improvement of uterus post-delivery
A woman may suffer from weakness and abdominal pain if the cancer has already began to circulate to other parts of the body. Cancer that reaches the kidneys and the liver may give rise to jaundice. Cancer spreading to the lungs can lead to nausea and breathing problems. Women who suffer from any unusual symptoms after or during their pregnancy should get a thorough check up done by an obstetrician.
Choriocarcinoma Causes
Medical researchers are still in the dark regarding the exact cause of this condition. Most cases of this disease arise when big, precancerous lumps known as Hydatidiform moles develop in uterine tissue at the beginning of pregnancy. A mole is basically a mass of extra placental tissue. It may obstruct development of the fetus. However, it is usually benign (non-dangerous) and does not cause any life-threatening complication in a woman.
A Choriocarcinoma occurs when a Hydatidiform mole becomes cancerous and the cells begin to multiply and disperse throughout the placenta. This is supposed to have some relation with pregnancy as some women suffer from tumors after ectopic pregnancies or spontaneous abortions. Testicular Choriocarcinomas are supposed to result from genetic reasons and undescended testes that may make some men susceptible to cancer.
Choriocarcinoma Diagnosis
Doctors generally diagnose this condition by studying the uterus and searching for lesions, moles and cysts. A small sample of the tissue may be collected and used for analysis in the laboratory. Diagnostic imaging tests may also be used to detect cancerous growths in other areas of the body. An obstetrician may also gather samples of blood to find out if the presence of viruses, autoimmune disorders or any other abnormal conditions is giving rise to these symptoms.
Women having this condition can test positive in a pregnancy examination even when they not in maternity. The level of pregnancy hormone (HCG) will constantly be high in such cases. A pelvic test may disclose extended uterine inflammation or even a tumor.
The condition may also be detected with the aid of blood tests like Quantitative serum HCG, Complete blood count, Kidney function tests and Liver function tests. Diagnostic examination may also involve imaging tests like MRI and CT scan. Blood tests help in checking the level of hormones in pregnancy.
An initial diagnosis is followed up by a careful consideration of the medical history of the patient. A medical examination is also performed to ensure that there has not been a spreading of cancer to other organs of the body. An Ultrasound Test is also performed in some cases to detect presence of tumors with the aid of sound waves.
Choriocarcinoma Treatment
An obstetrician generally follows up diagnosis with Chemotherapy sessions. Chemotherapy is generally successful in removing most tumors of this type. It is the main treatment for this disorder. Prognoses are usually very good in women after some months of treatment. Chemotherapy involves administering large doses of medicines to the patient to destroy cancerous cells. These medicines may be inserted into the physical system of the patient through injection or by oral means. Chemotherapy drugs move through the blood and aims cancerous cells.
If the tumor continues to grow despite Chemotherapy, a partial or total Hysterectomy surgery may be used to get rid of the impacted part of uterine tissue and prevent the dispersion of cancer. In some cases, this operative procedure also involves the surgical ablation of the uterus of suffering women. Most sufferers are fully able to recover from this disease with immediate medical cure and frequent checkups.
This type of tumor is believed to be very aggressive. This cancer can quickly disperse to the liver, brain, lungs and various other organs. In majority of individuals suffering from this condition, the cancer can be fully eliminated with the aid of consecutive chemotherapy treatments. If a tumor causes extensive damage to the tissues, a surgical operation may be required for total or partial removal of the uterus.
In rare cases, treatment involves Radiation Therapy and Hysterectomy. Radiation Therapy becomes necessary if the cancer affects the brain.
Choriocarcinoma Prognosis
The chance of recovery entirely depends on how much the cancer cells have spread into the human body. The outcome can be determined by the time of diagnosis. Diagnosing the condition earlier can improve the result. A patient who has already experienced a molar pregnancy needs to be monitored carefully. This may help detect the condition even before its advanced stages. Diagnosis of this disease in the early stages can increase the chance of recovery.
This cancerous condition can be cured very well in cases where there has not been any spread of cancer. Most women who are cured of this disease are seen to keep up a sound reproductive function.
Choriocarcinoma Complications
Complications for this condition include a recurrence of the disease. Choriocarcinoma recurrence generally happens within a few months. In rare cases however, the condition may recur even after 3 years.
The condition can become difficult to cure if
- The cancer spreads to vital organs like the brain or the liver
- HCG (Pregnancy hormone) level is more than 40,000 mIU per mL at the time when treatment starts
- Cancer recurs after a past case of Chemotherapy
- Pregnancy or Choriocarcinoma symptoms happen for over four months before the start of treatment
- Choriocarcinoma arises after a pregnancy that leads to the birth of an offspring
If symptoms of this condition arise within a year after the development of Hydatidiform mole, pregnancy or abortion, patients should immediately get in touch with a doctor. As aforesaid, early diagnosis and treatment can help patients make an early recovery from this condition.