Materiały źródłowe

• #1 Persistent trophoblastic disease and choriocarcinoma | nidirect

  https://www.nidirect.gov.uk/conditions/persistent-trophoblastic-disease-and-choriocarcinoma

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours. They are known as gestational trophoblastic tumours (GTTs). […] In a small number of women, the tissue can stay and grow further into the lining of the womb and, like a cancer, spread to other areas of the body. This is known as persistent trophoblastic disease. […] Vaginal bleeding is the most common symptom of persistent trophoblastic disease. Other symptoms include abdominal (tummy) swelling and anaemia. […] Choriocarcinoma is a very rare type of cancer that occurs in around one in 50,000 pregnancies. It can develop if the cells left behind after a pregnancy become cancerous. […] Although choriocarcinoma starts in the womb, it can spread to other parts of the body, most commonly, the lungs.

• #1 GTD Overview

  https://gynonc.nm.org/gtd-overview.html

  Gestational trophoblastic neoplasia (GTN) includes persistent postmolar gestational trophoblastic neoplasia, choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. The overall cure rate in treating these tumors at our center currently exceeds 90 percent. […] Choriocarcinoma is a malignant disease that can invade into the uterine walls and blood vessels resulting in spread to distant sites, such as the lungs, brain, liver, kidneys, intestines, spleen, and vagina. Choriocarcinoma affects about 1 in 40,000 pregnancies. Although choriocarcinoma can arise in association with any pregnancy, 50 percent arise from molar pregnancy. There are no characteristic signs or symptoms. […] Signs and Symptoms of postmolar GTN include persistent irregular vaginal bleeding and persistently enlarged uterus.

• #1 Gestational Trophoblastic Disease and Treatment

  https://www.froedtert.com/gynecological-cancer/gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is a rare group of tumors that involves abnormal cell growth in the uterus for women of childbearing age. […] GTDs include hydatidiform mole (or molar pregnancy), choriocarcinoma and placental site trophoblastic tumors. Most GTDs are non-cancerous, although some develop into cancer. […] Signs and Symptoms include pelvic pain or pressure, anemia, hyperemesis gravidarum (excessive vomiting during early pregnancy), hyperthyroidism, missed menstrual period with elevated human chorionic gonadotropin (HCG), abnormal uterine bleeding, and uterus less than or larger than expected for pregnancy dates. […] If a woman’s HCG levels fail to decrease after a procedure, additional treatment is recommended. GTD is extremely sensitive to anti-cancer drugs.

• #1 Persistent Trophoblastic Disease (Choriocarcinoma) | Symptoms, Diagnosis & Causes | Conditions | Healthera

  https://healthera.co.uk/conditions-a-z/persistent-trophoblastic-disease-choriocarcinoma/

  Persistent trophoblastic disease, also known as choriocarcinoma, is a rare type of cancer that can occur after pregnancy. It develops from a tissue that normally forms the placenta. […] The symptoms of choriocarcinoma can vary and may include: Abnormal bleeding from the vagina, which may happen after a pregnancy, Pelvic pain, A swollen abdomen or feeling of fullness, Nausea and vomiting, Shortness of breath if the cancer has spread to the lungs, Unexplained weight loss. […] Choriocarcinoma is a serious condition, but effective treatment is available. If you have any concerns or symptoms, its important to speak to your GP or healthcare provider as soon as possible.

• #1 Invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.nhs.uk/conditions/persistent-trophoblastic-disease-choriocarcinoma/

  Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD). Invasive mole is also called persistent trophoblastic disease (PTD). […] Some women may not have any symptoms. This is particularly the case for a woman with an invasive mole as these are usually picked up during follow up for a molar pregnancy. […] If there are symptoms, the main symptoms for an invasive mole or choriocarcinoma is vaginal bleeding.

• #1 Choriocarcinoma: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/24863-choriocarcinoma

  Choriocarcinoma is a rare and aggressive form of cancer that happens in your uterus or ovaries. […] Choriocarcinoma can spread quickly to other parts of your body, including your lungs, uterine muscle layer, lymph nodes, liver or kidneys, brain, and blood vessels. […] People with choriocarcinoma, especially people who were recently pregnant, may have the following symptoms: irregular vaginal bleeding and pelvic pain. […] You could develop other symptoms if choriocarcinoma spreads to other parts of your body. For example, once it spreads to your lungs, you may cough or have trouble breathing. Other symptoms could include heavy bleeding, abnormal discharge or lumps in your vagina (if it spreads to your vagina), seizures or headaches if it spreads to your brain, and pain in your abdomen if it spreads to your kidneys or liver.

• #1 Symptoms of invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/invasive-mole-choriocarcinoma/symptoms

  Invasive mole and choriocarcinoma are conditions that develop from placental cells. They are types of gestational trophoblastic disease (GTD). They both have similar symptoms. […] Choriocarcinoma can occur in the womb after a full term pregnancy, molar pregnancy, a miscarriage or a termination of pregnancy (abortion). It can cause vaginal bleeding. It can also spread to other parts of the body. The symptoms then depend on which part of the body it affects. […] You may have any of the following symptoms with invasive mole or choriocarcinoma: […] An invasive mole most commonly occurs in the womb, so vaginal bleeding is the most common symptom. If you continue to have vaginal bleeding for longer than usual after a normal pregnancy or a molar pregnancy, contact your doctor. […] Invasive mole and choriocarcinoma start in the womb but can spread to other parts of the body. The most common place is the lungs, but it can also spread to other areas. […] These symptoms sound very frightening. But invasive mole and choriocarcinoma are nearly always cured, even if they have spread to other parts of the body.

• #1 Choriocarcinoma Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/choriocarcinoma

  Choriocarcinoma is a fast-growing cancer that occurs in a woman’s uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. The placenta is the organ that develops during pregnancy to feed the fetus. […] Choriocarcinoma is a type of gestational trophoblastic disease. […] A possible symptom is abnormal or irregular vaginal bleeding in a woman who recently had a hydatidiform mole or pregnancy. Other symptoms may include: Irregular vaginal bleeding, Pain, which may be associated with the bleeding, or due to enlargement of the ovaries that often occurs with a choriocarcinoma. […] Most women whose cancer has not spread can be cured and will still be able to have children. A choriocarcinoma may come back within a few months to 3 years after treatment. The condition is harder to cure if the cancer has spread and one or more of the following happens: Disease spreads to the liver or brain, Pregnancy hormone (HCG) level is higher than 40,000 mIU/mL when treatment begins, Cancer returns after having chemotherapy, Symptoms or pregnancy occurred for more than 4 months before treatment began, Choriocarcinoma occurred after a pregnancy that resulted in the birth of a child. […] Contact your health care provider if you develop symptoms within 1 year after a hydatidiform mole or pregnancy.

• #1 Ministry of Health | Safe Mama Uganda

  https://safemama.health.go.ug/records/resource?id=40

  CLINICAL MANIFESTATIONS: A premenopausal woman with abnormal vaginal bleeding and: […] Choriocarcinoma: It is the most aggressive GTN, and is characterized by early vascular invasion and widespread metastases and irregular vaginal bleeding […] Other clinical features include: […] Enlarged uterus and bilateral ovarian cysts. […] Vaginal metastases (very vascular and prone to bleeding and infection). […] Clinical features: […] Irregular vaginal bleeding […] Enlarged uterus are common […] A plateau or rise in hCG suggests persistent trophoblastic disease, and necessitates chemotherapeutic treatment. […] Histologic confirmation of choriocarcinoma necessitates referral.

• #1 Gestational Trophoblastic Disease | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gestational-trophoblastic-disease

  A woman with an hydatidiform mole (partial or complete) or choriocarcinoma may experience one or more of these symptoms: irregular, non-menstrual vaginal bleeding, possibly with blood clots or a watery brown discharge; pelvic pain or discomfort; nausea and vomiting that are more frequent and severe than what a woman typically experiences during a normal pregnancy; fatigue and shortness of breath due to anemia resulting from blood loss through vaginal bleeding; faster growth than expected for weeks of pregnancy, due to extension of the uterus; rapid heartbeat, warm skin, and mild tremor or shaking; caused by an overactive thyroid gland, this complication may occur rarely in women with high HCG levels; preeclampsia (also known as toxemia)a pregnancy-related condition which can cause a sharp rise in blood pressure.

• #1 Choriocarcinoma: Symptoms, Treatment, and Survival Rates Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/choriocarcinoma-symptoms-treatment-and-survival-rates-explained/

  Elevated levels of human chorionic gonadotropin (hCG) are present in nearly 100% of choriocarcinoma cases. […] Shortness of breath occurs in approximately 20-30% of patients with choriocarcinoma, particularly if the cancer has spread to the lungs. […] A persistent cough occurs in 20-30% of patients with choriocarcinoma, especially if the cancer has spread to the lungs. […] Fatigue is a common symptom in many cancer patients, including those with choriocarcinoma, affecting about 50-60% of patients. […] Unexplained weight loss occurs in approximately 30-40% of choriocarcinoma patients. […] A pelvic mass is detected in about 50-60% of patients with choriocarcinoma. […] Nausea is a less common symptom, occurring in about 20-30% of patients with choriocarcinoma. […] Headaches are reported in about 10-20% of patients with choriocarcinoma, particularly if the cancer has spread to the brain.

• #1 Gestational Trophoblastic Disease Treatment – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/patient/gtd-treatment-pdq

  Gestational trophoblastic neoplasia (GTN) is a type of gestational trophoblastic disease (GTD) that is almost always malignant. […] Signs of GTD include abnormal vaginal bleeding and a uterus that is larger than normal. […] A choriocarcinoma is a malignant tumor that forms from trophoblast cells and spreads to the muscle layer of the uterus and nearby blood vessels. It may also spread to other parts of the body, such as the brain, lungs, liver, kidney, spleen, intestines, pelvis, or vagina. […] GTD sometimes causes an overactive thyroid. Signs and symptoms of an overactive thyroid include the following: Fast or irregular heartbeat, shakiness, sweating, frequent bowel movements, trouble sleeping, feeling anxious or irritable, weight loss. […] Recurrent gestational trophoblastic neoplasia (GTN) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus or in other parts of the body. […] Gestational trophoblastic neoplasia that does not respond to treatment is called resistant GTN.

• #1 Choriocarcinoma: Symptoms, Causes, Diagnosis, Treatment

  https://www.webmd.com/cancer/what-is-choriocarcinoma

  This rare type of tumor that most often affects pregnant women is called a gestational choriocarcinoma. It is a type of gestational trophoblastic disease (GTD). […] The cancer usually starts in your uterus but can spread to other parts of the body. […] If the choriocarcinoma is in your vagina, it could cause bleeding. If it has spread to your abdomen, you might also have pain or pressure there. […] If it has spread to other parts of your body like your lungs or brain, you may notice: Cough, Trouble breathing, Chest pain, Headache, Dizziness.

• #1 Persistent trophoblastic disease and choriocarcinoma – Know Your Doctor

  https://www.knowyourdoctor.com.cy/medical/persistent-trophoblastic-disease-and-choriocarcinoma/

  Persistent trophoblastic disease and choriocarcinoma are very rare pregnancy-related tumours known as gestational trophoblastic tumours (GTTs). Vaginal bleeding is the most common symptom of persistent trophoblastic disease. […] Choriocarcinoma is a very rare type of cancer that occurs in around 1 in 50,000 pregnancies. If it spreads to your lungs, you may have symptoms such as coughing, difficulty breathing and chest pain. If choriocarcinoma spreads to your abdomen, you may experience abdominal pain. If it spreads to your vagina, you may have heavy bleeding and a lump (nodule) may develop on your vagina. If it spreads to your brain, it may cause headaches or seizures.

• #1 Gestational Trophoblastic Disease (GTD) | Foundation For Women’s Cancer

  https://foundationforwomenscancer.org/gynecologic-cancers/gestational-trophoblastic-disease-gtd/

  Choriocarcinoma is a highly malignant form of GTD that spreads rapidly throughout the body and requires vigorous treatment. Women who develop choriocarcinoma may be symptom-free or experience symptoms based on which organ(s) are involved: Uterus: Vaginal bleeding, discharge; Lung: Coughing up blood, shortness of breath or chest pain; Liver: Abdominal pain; Brain: Headache, trouble with vision, convulsion, weakness or loss of function; Kidney: Blood in urine; Bowel: Blood in stool.

• #1 Persistent trophoblastic disease and choriocarcinoma | nidirect

  https://www.nidirect.gov.uk/conditions/persistent-trophoblastic-disease-and-choriocarcinoma

  The symptoms of choriocarcinoma depend on where the cancer has spread to. Spread of cancer to the vagina can cause heavy bleeding and/or a lump (nodule) in the vagina; to the lungs can cause symptoms including cough, difficulty breathing and chest pain; to the abdomen (tummy) can cause abdominal pain; to the brain may cause headaches or seizures. […] Overall, the outlook for persistent trophoblastic disease and choriocarcinoma is excellent. 98 to 100 per cent of women who develop a gestational trophoblastic cancer are cured.

• #1 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Most cases of GTN are diagnosed when the serum hCG levels plateau or rise in patients being observed after the diagnosis of hydatidiform mole. If metastases have developed, the following signs and symptoms may be noted: […] Metastasis to the lower genital tract presents as purple to blue-black papules or nodules, which are extremely vascular and may bleed profusely if biopsied […] Abdominal tenderness, if liver or gastrointestinal metastases have occurred […] Abdominal guarding and rebound tenderness, if a hemoperitoneum has occurred due to bleeding from an abdominal metastasis […] Bleeding from a metastasis could also result in signs and symptoms of hemorrhagic shock […] Neurologic deficits, from lethargy to coma, if brain metastasis has occurred […] Jaundice, if liver metastasis causes biliary obstruction.

• #1 Gestational Trophoblastic Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/6130-gestational-trophoblastic-disease

  Common symptoms of a molar pregnancy include abnormal vaginal bleeding early in a suspected pregnancy, which can be red or watery brown, and sometimes include abdominal pain. […] Some people don’t have any symptoms, but in those who do, the most common is abnormal vaginal bleeding after pregnancy, miscarriage or molar pregnancy. Some people have abdominal pain or blood in their pee or poop. […] Gestational trophoblastic disease may cause an overactive thyroid. Signs of an overactive thyroid include fast heartbeat, shakiness, weight loss, and sweating. […] Most GTD cases are treated and cured, especially when diagnosed early. But cases of advanced GTD can be fatal.

• #1 Persistent gestational trophoblastic disease following ovarian molar pregnancy: A case report of a rare entity with review of the literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8405531/

  Ovarian molar pregnancy, though a very rare entity, behaves like any other molar pregnancy. After surgical management, close followup with hCG surveillance is invariable to detect progression to persistent gestational trophoblastic disease. […] Careful Beta Human Chorionic Gonadotrophin (hCG) surveillance is necessary to detect progression to persistent gestational trophoblastic disease (GTD). The persistent GTD is when women retain some molar tissue despite being treated to remove it and occurs in about 8% of women with molar pregnancy. It can spread like cancer but has a cure rate of nearly 100% with chemotherapy. […] In 15% complete and 1% partial molar pregnancies, some remaining abnormal cells are present in the deeper tissues where it was found initially. This is known as a persistent gestational tumor, it can spread to a distant sites and might cause symptoms there. Thus chemotherapy is indicated to completely eradicate the abnormal cells.

• #1 Gestational trophoblastic disease – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_trophoblastic_disease

  Vaginal bleeding, enlarged uterus, pelvic pain or discomfort, and vomiting too much (hyperemesis) are the most common symptoms of GTD. […] Women with persistent abnormal vaginal bleeding after any pregnancy, and women developing acute respiratory or neurological symptoms after any pregnancy, should also undergo hCG testing, because these may be signs of a hitherto undiagnosed GTD. […] In women who have a malignant form of GTD, hCG concentrations stay the same (plateau) or they rise. Persistent elevation of serum hCG levels after a non molar pregnancy (i.e., normal pregnancy [term pregnancy], or preterm pregnancy, or ectopic pregnancy [pregnancy taking place in the wrong place, usually in the fallopian tube], or abortion) always indicate persistent GTD (very frequently due to choriocarcinoma or placental site trophoblastic tumour), but this is not common, because treatment mostly is successful.

• #1 What Is Gestational Trophoblastic Disease?

  https://www.webmd.com/cancer/gestational_trophoblastic_disease

  Yellowing of the skin (jaundice) […] GTD may cause stimulation of the thyroid gland and hyperthyroidism […] Fast, irregular heartbeat […] Shakiness […] Sweating […] Weight loss […] if the GTD is cancerous and has spread (metastasized), the symptoms would be related to where the cancer has spread. First site of metastases is usually the lungs, but they can also metastasize to the brain, bones, etc.

• #1 Gestational Trophoblastic Disease Symptoms & Diagnosis | Herbert Irving Comprehensive Cancer Center (HICCC) – New York

  https://www.cancer.columbia.edu/cancer-types-care/types/gestational-trophoblastic-disease/about-gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is the name given to a group of rare tumors that develop during early pregnancy. […] However, some could become malignant and spread to nearby tissues or distant parts of the body. […] Some of the symptoms caused by GTD can include: Vaginal bleeding during pregnancy or not related to menstruation, Uterine size larger than expected during pregnancy, Severe nausea and vomiting during pregnancy, High blood pressure, with headache and swelling early during pregnancy, Shortness of breath, dizziness, and fast and irregular heartbeat caused by anemia during pregnancy, Signs of thyroid irregularities: feeling tired, short of breath, fast heartbeat, shakiness, sweating, trouble sleeping, weight loss, more frequent bowel movements. […] Gestational trophoblastic neoplasia (GTN) is considered cancerous and can spread to other parts of the body. […] When GTN spreads to another part of the body, it is called metastasis.

• #1 Gestational Trophoblastic Disease Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/gestational-trophoblastic/hp/gtd-treatment-pdq

  The probability of cure depends on the following: histological type (invasive mole or choriocarcinoma), extent of spread of the disease/largest tumor size, level of serum beta-hCG, duration of disease from the initial pregnancy event to start of treatment, number and specific sites of metastases, nature of antecedent pregnancy, and extent of prior treatment. […] Chemotherapy is necessary when there is a rising beta-hCG titer for 2 weeks, a tissue diagnosis of choriocarcinoma, a plateau of the beta-hCG for 3 weeks, persistence of detectable beta-hCG 6 months after mole evacuation, metastatic disease, an elevation in beta-hCG after a normal value, or postevacuation hemorrhage not caused by retained tissues. […] In women with complete HM, risk of persistence or neoplastic transformation is approximately doubled in the setting of certain characteristics, which include age older than 35 years or younger than 20 years, pre-evacuation serum beta-hCG greater than 100,000 IU/L, large-for-date uterus, large uterine molar mass, large (6 cm) ovarian cysts, preeclampsia, hyperthyroidism, hyperemesis of pregnancy, trophoblastic embolization, and disseminated intravascular coagulation.

• #1 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  After a complete molar pregnancy, approximately 15% of patients will have persistent local disease with invasion, and 5% may develop metastatic disease. […] The presentation of a partial HM is typically less dramatic than that of a complete HM. […] The healthcare professional should conduct a thorough history and physical examination for any patient with suspected choriocarcinoma. […] Choriocarcinoma tends to metastasize, and clinicians should note symptoms that arise from other organ systems, for example, hemoptysis or gastrointestinal (GI) bleeding. […] Without treatment, choriocarcinoma can result in death. […] The prognosis for patients with localized high-risk and metastatic, low-risk GTD is also very good. […] Most high-risk GTN patients present with metastases months or years following the causative pregnancy. […] Signs and symptoms differ according to the disease’s location. […] High clinical suspicion should be maintained for choriocarcinoma in women with hemoptysis and molar pregnancy, current or recent pregnancy, or irregular vaginal bleeding.

• #1 Update on gestational trophoblastic disease – O&G Magazine

  https://www.ogmagazine.org.au/24/3-24/update-on-gestational-trophoblastic-disease/

  CHM have a malignant potential of 20% and a 5% chance of distant metastatic spread. PHM carry a malignant potential of 0.55%. […] If the hCG is 5000 IU/L, and residual, non-myoinvasive, uterine confined disease is identified on ultrasound, a second curettage by an experienced practitioner can be considered. […] Given GTN is exquisitely sensitive to chemotherapy, consideration should be given to a diagnosis of non-gestational choriocarcinoma (where a non-pregnancy related malignancy has de-differentiated into choriocarcinoma) if the response to chemotherapy is not as expected.

• #1 A Rare Case of Choriocarcinoma following a Normal Pregnancy and Delivery – International Journal of Recent Surgical and Medical Sciences

  https://ijrsms.com/a-rare-case-of-choriocarcinoma-following-a-normal-pregnancy-and-delivery/

  The incidence of choriocarcinoma after complete hydatiditorm mole is about 1,000 times greater than after a normal pregnancy. […] Choriocarcinoma is a rare tumor. […] Choriocarcinoma, also known as chorioblastoma or trophoblastic tumor, is a rare form of cancer that occurs in the female genital tract. […] These cases present with vaginal bleeding, anemia, hyperemesis gravidarum, hyperthyroidism, uterine and ovarian enlargement, and pregnancy-induced hypertension. […] Choriocarcinoma was often diagnosed after the mother developed symptoms of metastasis postpartum. The symptoms included vaginal bleeding, chest pain, and neurological signs, such as seizures and stroke. […] The present study concluded that although postpartum choriocarcinoma is an extremely rare condition, it is important for obstetricians and gynecologists to remain aware of this possibility in patients with persistent postpartum vaginal bleeding. […] Although postpartum choriocarcinoma is extremely uncommon, there is need for obstetrician to be aware of this possibility in cases of persistent postpartum vaginal bleeding.

• #1

  http://www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-management-manual/gynecology/gestational-trophoblastic-neoplasia

  Gestational trophoblastic diseases (GTD) are characterized by abnormal proliferation of trophoblasts. When they cause local invasion or metastasize, they are called gestational trophoblastic neoplasia (GTN). […] The diagnosis of GTN does not require histopathology. Diagnosis is made solely with serum testing of hCG levels. […] The index pregnancy (last pregnancy before development of the GTN) is most often a molar pregnancy (50%) but can also be a spontaneous abortion/ectopic pregnancy (25%) or a term/preterm pregnancy (25%). […] The diagnostic criteria for a GTN are: A plateau (+/- 10%) in hCG levels over at least 3 weeks (i.e. 4 consecutive values); A rise ( 10%) in hCG levels over at least 2 weeks (i.e. 3 consecutive values); Persistence of hCG at 6 months after molar evacuation; Histologic evidence of choriocarcinoma; Presence of metastatic disease.

• #1 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN can metastasize and be fatal if not treated. […] Choriocarcinoma is a rare and aggressive neoplasm. […] Choriocarcinoma predominately occurs in women but can also occur in men, usually as part of a mixed germ cell tumor. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] When GTN develops after a molar pregnancy, it is usually an invasive mole or choriocarcinoma, rarely an ETT or a PSTT.

• #1 Advances in the diagnosis and early management of gestational trophoblastic disease | BMJ Medicine

  https://bmjmedicine.bmj.com/content/1/1/e000321

  Choriocarcinoma is the most aggressive form of GTN with a reported incidence of one per 40000 pregnancies in Europe and North America compared with 9.2 per 40000 pregnancies in South East Asia. […] In April 2020, a larger UK based study of 234 cases reported metastasis in more than 50% of women with non-molar derived choriocarcinoma. […] The diagnosis of GTN is largely based on a combination of obstetric history and elevated concentrations of hCG. […] After molar pregnancy, plateaued or rising hCG concentrations are indicative of GTN. […] However, some women develop disease persistence and progress to malignant disease requiring chemotherapy or further surgical intervention. […] Importantly, all guidelines recommend that GTN should be considered in the differential diagnosis of all women who present with irregular vaginal bleeding after pregnancy and that serum hCG measurement should be included in the diagnostic investigations.

• #1 What is Gestational Trophoblastic Disease? A Complete Guide

  https://womenandchildren.avisena.com.my/health-articles/gestational-trophoblastic-disease-symptoms-treatment-more/

  Gestational Trophoblastic Disease can be life-threatening if left untreated, yet it is highly treatable in most cases with early diagnosis. […] Recognising the symptoms of gestational trophoblastic disease is vital for early intervention. Common symptoms include: Persistent vaginal bleeding during or after pregnancy. […] In gestational trophoblastic disease, HCG levels are abnormally high and often exceed normal pregnancy ranges, reflecting the excessive growth of trophoblastic tissue. […] Early detection of Gestational Trophoblastic Disease not only ensures effective treatment but also minimises complications, especially in malignant cases. […] The prognosis for gestational trophoblastic disease is generally excellent, particularly with early detection and appropriate treatment. Most cases, especially hydatidiform moles and low-risk GTD respond well to surgical removal and, if necessary, chemotherapy.

• #1 Persistent gestational trophoblastic disease following ovarian molar pregnancy: A case report of a rare entity with review of the literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8405531/

  The persistence of GTD is defined as a persistent elevation of hCG, and the condition is also known as gestational trophoblastic neoplasia (GTN). GTN generally is symptomless, and hence, the diagnosis is made by regular hCG surveillance. […] With the improvement in management approach, regular followup protocols, and the use of human chorionic gonadotropin as a biomarker, overall cure rates can exceed 98% with fertility retention. Frequent monitoring of hCG for at least 12 months with reliable contraception is essential for the surveillance of relapse. […] Careful followup with hCG surveillance is required to identify progression to persistent GTD. Despite the need for a long course of treatment, persistent GTD can be successfully by chemotherapy.

• #1 Update on gestational trophoblastic disease – O&G Magazine

  https://www.ogmagazine.org.au/24/3-24/update-on-gestational-trophoblastic-disease/

  Gestational trophoblastic neoplasia (GTN) includes the malignant gestational trophoblastic disease conditions of persistent trophoblastic disease, invasive mole, choriocarcinoma, placental site trophoblastic tumour (PSTT) and epithelioid trophoblastic tumour (ETT). Overall, GTN affects fewer than 1/40,000 pregnancies and the latter two conditions are extremely rare, affecting at most 1/50,000 pregnancies. GTN can be thought of as GTD that behaves in a malignant fashion, thus requiring further treatment in the form of chemotherapy and/or surgery when human Chorionic Gonadotrophin (hCG) levels are persistent, rising or metastatic disease is detected. […] Vaginal bleeding, which is the most common first presentation of gestational trophoblastic disease, will often trigger an ultrasonographic evaluation. Classic ultrasound findings of CHM are an intrauterine snowstorm appearance and theca lutein cysts, but earlier and more advanced ultrasound assessment more commonly demonstrates a complex intra-uterine mass with no fetal parts and a cystic appearance of the placenta.

• #1 Gestational Trophoblastic Neoplasia – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/gestational-trophoblastic-neoplasia

  Gestational trophoblastic neoplasia (GTN) refers to a group of cancers that develop from an abnormal growth of cells normally found in the placenta. […] Choriocarcinoma: A fast-growing type of GTN that develops from trophoblastic cells, specifically the cytotrophoblasts and syncytiotrophoblasts, which should have formed a part of a normal placenta. […] Symptoms and Diagnosis […] Persistent bleeding after a miscarriage, termination (abortion) or delivery […] Persistent lack of menstruation following miscarriage, termination (abortion) or delivery […] Abdominal pain or cramping […] Enlarged uterus and/or ovarian cysts […] Persistently positive pregnancy test […] Pelvic pain or pressure […] Cough, shortness of breath […] Headaches or seizures. […] If the initial tumor returns or does not go away with treatment, a full work-up to restage the tumor is performed. This usually includes more bloodwork and a physical exam. Patients also undergo a CT scan or MRI to investigate whether the disease has spread. If the tumor recurs, patients can receive single-drug chemotherapy treatment, but many recurrent tumors require a multi-drug chemotherapy regimen. Even still, many patients can be cured of their disease with the use of the appropriate chemotherapy drugs.

• #1

  https://journals.lww.com/md-journal/fulltext/2018/10190/choriocarcinoma_with_brain_metastasis_after_term.82.aspx

  Postpartum choriocarcinoma is usually diagnosed based on symptoms due to metastatic lesions, such as abnormal vaginal bleeding; abdominal, pulmonary, and cerebral hemorrhage; coughing; hemoptysis; and hemiplegia. […] Delayed diagnosis of postpartum choriocarcinoma may increase the risk of metastasis and monochemotherapy resistance, thus affecting its prognosis. […] The high-risk factors for poor prognosis of postpartum choriocarcinoma after term pregnancy accompanied with metastasis are a lesion 5.0 cm in size, a -HCG level 30,000 IU/mL before treatment, changes in maternal immune responses, and delayed diagnosis ( 6 months). […] An accurate diagnosis of postpartum choriocarcinoma at an early stage can significantly improve its prognosis.

• #1 Choriocarcinoma: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/24863-choriocarcinoma

  Choriocarcinomas happen when cells that form the placenta (called trophoblasts) become cancerous. […] It spreads quickly and is considered an aggressive type of cancer. […] Because this type of cancer spreads quickly, not getting treatment for choriocarcinoma can be fatal. […] Yes, choriocarcinoma is curable. Treatment with chemotherapy is usually successful in curing it. […] The prognosis is better when choriocarcinoma is caught early, before it spreads to other parts of your body. […] Non-gestational choriocarcinoma (not related to a prior abnormal pregnancy/placental tissue) has a worse prognosis and is less chemosensitive, which means chemotherapy may not be as effective in killing the cancer cells.

• #1 Gestational Trophoblastic Disease | Vanderbilt-Ingram Cancer Center

  https://vicc.org/cancer-info/adult-gestational-trophoblastic-disease

  The treatment of gestational trophoblastic neoplasia is based on the type of disease, stage, or risk group. […] Recurrent gestational trophoblastic neoplasia (GTN) is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus or in other parts of the body. […] Gestational trophoblastic neoplasia that does not respond to treatment is called resistant GTN.

• #2 Gestational trophoblastic disease – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_trophoblastic_disease

  The term persistent trophoblastic disease (PTD) is used when after treatment of a molar pregnancy, some molar tissue is left behind and again starts growing into a tumour. Although PTD can spread within the body like a malignant cancer, the overall cure rate is nearly 100%. […] Choriocarcinoma, for example, is an uncommon, yet almost always curable cancer. 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.

• #2 Stages of gestational trophoblastic disease (GTD) | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/gestational-trophoblastic-disease/staging

  Cancerous gestational trophoblastic disease (GTD) is also called gestational trophoblastic neoplasia (GTN). […] Usually any abnormal trophoblast cells left behind after a hydatidiform mole is removed will die off. In some cases, these trophoblast cells will keep growing and can become an invasive mole. An invasive mole that develops after a hydatidiform mole is removed may also be called a persistent mole or persistent trophoblastic disease.

• #2 Choriocarcinoma: Symptoms, Treatment, and Survival Rates Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/choriocarcinoma-symptoms-treatment-and-survival-rates-explained/

  Choriocarcinoma is a rare but aggressive cancer that originates in the placenta, the organ responsible for nourishing a developing fetus during pregnancy. This cancer is part of a broader group of diseases known as gestational trophoblastic disease (GTD). Choriocarcinoma can spread rapidly to other parts of the body, such as the lungs, liver, and brain, making early detection and treatment crucial for a positive outcome. […] Vaginal bleeding is the most common symptom of choriocarcinoma, occurring in approximately 90% of patients. This bleeding is often irregular and can range from light spotting to heavy bleeding. […] Abdominal pain is reported in about 40-50% of choriocarcinoma patients. The pain is typically caused by the tumor invading the uterus and surrounding tissues, leading to inflammation and pressure on nearby organs.

• #2 Gestational Trophoblastic Disease and Treatment

  https://www.froedtert.com/gynecological-cancer/gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is a rare group of tumors that involves abnormal cell growth in the uterus for women of childbearing age. […] GTDs include hydatidiform mole (or molar pregnancy), choriocarcinoma and placental site trophoblastic tumors. Most GTDs are non-cancerous, although some develop into cancer. […] Signs and Symptoms include pelvic pain or pressure, anemia, hyperemesis gravidarum (excessive vomiting during early pregnancy), hyperthyroidism, missed menstrual period with elevated human chorionic gonadotropin (HCG), abnormal uterine bleeding, and uterus less than or larger than expected for pregnancy dates. […] If a woman’s HCG levels fail to decrease after a procedure, additional treatment is recommended. GTD is extremely sensitive to anti-cancer drugs.

• #2 Invasive mole and choriocarcinoma | Gestational trophoblastic disease (GTD) | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/gestational-trophoblastic-disease-gtd/invasive-mole-choriocarcinoma

  Invasive mole and choriocarcinoma are very rare types of cancer that can occur after pregnancy. They are types of gestational trophoblastic disease (GTD). Invasive mole is also called persistent trophoblastic disease (PTD. […] If there are symptoms, the main symptoms for an invasive mole or choriocarcinoma is vaginal bleeding. […] Some women may not have any symptoms. This is particularly the case for a woman with an invasive mole as these are usually picked up during follow up for a molar pregnancy.

• #2 Gestational Trophoblastic Disease (GTD): Symptoms, Causes, Diagnosis, Treatment & Prevention

  https://iswarya.com/gestational-trophoblastic-disease-gtd/

  Gestational Trophoblastic Disease (GTD) is a group of rare conditions in which abnormal growth of trophoblastic cells (cells that normally form the placenta during pregnancy) occurs. These conditions primarily affect the pregnancy but can also become cancerous in some cases. GTD encompasses a range of disorders, from benign conditions like hydatidiform mole (molar pregnancy) to more aggressive forms such as choriocarcinoma. […] Symptoms of a molar pregnancy include: Vaginal bleeding, Larger-than-normal uterus for gestational age, Severe morning sickness or hyperemesis gravidarum, Absence of fetal heartbeat, Elevated levels of human chorionic gonadotropin (hCG). […] Choriocarcinoma is a highly malignant form of GTD that arises from either a molar pregnancy, an abortion, or a normal pregnancy. This form of cancer is aggressive and can spread rapidly to the lungs, liver, and other parts of the body. It is extremely rare but treatable with chemotherapy.

• #2 Gestational Trophoblastic Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470267/

  Gestational trophoblastic disease (GTD) is a group of tumors defined by abnormal trophoblastic proliferation involving both benign and malignant entities. […] The nonmolar or malignant forms of GTD are called gestational trophoblastic neoplasia (GTN) and include the invasive mole, choriocarcinoma, epithelioid trophoblastic tumor (ETT), and placental-site trophoblastic tumor (PSTT). […] GTN can metastasize and be fatal if not treated. […] Choriocarcinoma is a rare and aggressive neoplasm. […] Choriocarcinoma predominately occurs in women but can also occur in men, usually as part of a mixed germ cell tumor. […] Choriocarcinoma develops from an abnormal trophoblastic population undergoing hyperplasia and anaplasia, most frequently following a molar pregnancy. […] When GTN develops after a molar pregnancy, it is usually an invasive mole or choriocarcinoma, rarely an ETT or a PSTT.

• #2 Pathology Outlines – Choriocarcinoma

  https://www.pathologyoutlines.com/topic/placentachoriocarcinoma.html

  Vaginal bleeding is the most common symptom […] Can also present initially with metastatic disease, especially after nonmolar pregnancies, in the lungs (dyspnea, hemoptysis), lower genital tract (violet nodules located in the vulva, vagina or cervix), liver (abnormal liver function, intraabdominal hemorrhage) and brain (neurologic symptoms, e.g. convulsion, altered mental status)

• #2 Choriocarcinoma: Symptoms, Treatment, and Survival Rates Explained – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/choriocarcinoma-symptoms-treatment-and-survival-rates-explained/

  Elevated levels of human chorionic gonadotropin (hCG) are present in nearly 100% of choriocarcinoma cases. […] Shortness of breath occurs in approximately 20-30% of patients with choriocarcinoma, particularly if the cancer has spread to the lungs. […] A persistent cough occurs in 20-30% of patients with choriocarcinoma, especially if the cancer has spread to the lungs. […] Fatigue is a common symptom in many cancer patients, including those with choriocarcinoma, affecting about 50-60% of patients. […] Unexplained weight loss occurs in approximately 30-40% of choriocarcinoma patients. […] A pelvic mass is detected in about 50-60% of patients with choriocarcinoma. […] Nausea is a less common symptom, occurring in about 20-30% of patients with choriocarcinoma. […] Headaches are reported in about 10-20% of patients with choriocarcinoma, particularly if the cancer has spread to the brain.

• #2 Gestational Trophoblastic Disease | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is a group of rare tumors that begin during a pregnancy. These tumors start in the cells that would normally develop into the placenta, which connects the fetus to the uterus. […] GTD can be benign (not cancerous) or malignant (cancerous). […] In contrast, all choriocarcinomas, PSTTs, and ETTs are considered cancerous. […] A choriocarcinoma is even rarer than a hydatidiform mole. This type of GTD may have begun as a hydatidiform mole or may arise from tissue that remains in the uterus following a miscarriage or full-term delivery of a baby. […] Unlike a hydatidiform mole, a choriocarcinoma is a malignant and more aggressive form of GTD that spreads into the muscle wall of the uterus. A choriocarcinoma can also spread more widely to other parts of the body such as the lungs, liver, and/or brain.

• #2 Gestational trophoblastic disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/gestational-trophoblastic-disease/

  Gestational trophoblastic disease (GTD) is a class of neoplastic conditions characterized by abnormal trophoblast-cell growth in the uterus. Typical symptoms of GTD are vaginal bleeding and pelvic tenderness. Additional features of complete moles include enlarged uterus, hyperemesis gravidarum, and preeclampsia. If GTN is suspected, workup must include x-ray of the chest to screen for lung metastases. Hydatidiform moles are typically treated via suction evacuation and curettage, whereas GTN treatment typically starts with chemotherapy. […] Choriocarcinoma: a highly malignant GTN characterized by invasive, highly vascular, and anaplastic trophoblastic tissue without villi. Has the tendency to metastasize to the lungs, vagina, CNS, liver, pelvis, GI tract, and kidneys. Clinical features: depend on disease extension and metastases location. Postpartum vaginal bleeding and inadequate uterine regression after delivery. Additional symptoms according to the site of metastasis e.g.: Dyspnea, cough, or hemoptysis from metastases in the lungs. Seizures, headaches from metastases in the brain. Visible vascular lesions from metastases to the vagina. […] Persistent vaginal bleeding after evacuation of molar pregnancy. Enlarged uterus. Dyspnea or hemoptysis with lung metastases. The risk of malignant GTN is higher in complete mole than in partial mole.

• #2 Choriocarcinoma Cancer: Symptoms, Causes, Treatment and Diagnosis | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/choriocarcinoma-cancer-symptoms-causes-treatment-and-diagnosis/

  However, if cancer has metastasized to other body parts, you may suffer from the following: Dry cough, Difficulty breathing, Coughing blood, Chest pain, Headache, Lightheadedness. […] A cancer diagnosis of any kind is concerning. However, if you are diagnosed with choriocarcinoma, the prognosis is excellent. It is rare cancer that metastasizes fast and rapidly spreads to other body parts.

• #2 Gestational Trophoblastic Neoplasia – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/gestational-trophoblastic-neoplasia

  Gestational trophoblastic neoplasia (GTN) refers to a group of cancers that develop from an abnormal growth of cells normally found in the placenta. […] Choriocarcinoma: A fast-growing type of GTN that develops from trophoblastic cells, specifically the cytotrophoblasts and syncytiotrophoblasts, which should have formed a part of a normal placenta. […] Symptoms and Diagnosis […] Persistent bleeding after a miscarriage, termination (abortion) or delivery […] Persistent lack of menstruation following miscarriage, termination (abortion) or delivery […] Abdominal pain or cramping […] Enlarged uterus and/or ovarian cysts […] Persistently positive pregnancy test […] Pelvic pain or pressure […] Cough, shortness of breath […] Headaches or seizures. […] If the initial tumor returns or does not go away with treatment, a full work-up to restage the tumor is performed. This usually includes more bloodwork and a physical exam. Patients also undergo a CT scan or MRI to investigate whether the disease has spread. If the tumor recurs, patients can receive single-drug chemotherapy treatment, but many recurrent tumors require a multi-drug chemotherapy regimen. Even still, many patients can be cured of their disease with the use of the appropriate chemotherapy drugs.

• #2 Gestational Trophoblastic Disease (GTD) | Foundation For Women’s Cancer

  https://foundationforwomenscancer.org/gynecologic-cancers/gestational-trophoblastic-disease-gtd/

  Choriocarcinoma is a highly malignant form of GTD that spreads rapidly throughout the body and requires vigorous treatment. Women who develop choriocarcinoma may be symptom-free or experience symptoms based on which organ(s) are involved: Uterus: Vaginal bleeding, discharge; Lung: Coughing up blood, shortness of breath or chest pain; Liver: Abdominal pain; Brain: Headache, trouble with vision, convulsion, weakness or loss of function; Kidney: Blood in urine; Bowel: Blood in stool.

• #2 Gestational Trophoblastic Neoplasia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/279116-overview

  Most cases of GTN are diagnosed when the serum hCG levels plateau or rise in patients being observed after the diagnosis of hydatidiform mole. If metastases have developed, the following signs and symptoms may be noted: […] Metastasis to the lower genital tract presents as purple to blue-black papules or nodules, which are extremely vascular and may bleed profusely if biopsied […] Abdominal tenderness, if liver or gastrointestinal metastases have occurred […] Abdominal guarding and rebound tenderness, if a hemoperitoneum has occurred due to bleeding from an abdominal metastasis […] Bleeding from a metastasis could also result in signs and symptoms of hemorrhagic shock […] Neurologic deficits, from lethargy to coma, if brain metastasis has occurred […] Jaundice, if liver metastasis causes biliary obstruction.

• #2 What Is Gestational Trophoblastic Disease?

  https://www.webmd.com/cancer/gestational_trophoblastic_disease

  Yellowing of the skin (jaundice) […] GTD may cause stimulation of the thyroid gland and hyperthyroidism […] Fast, irregular heartbeat […] Shakiness […] Sweating […] Weight loss […] if the GTD is cancerous and has spread (metastasized), the symptoms would be related to where the cancer has spread. First site of metastases is usually the lungs, but they can also metastasize to the brain, bones, etc.

• #2 Gestational choriocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Gestational_choriocarcinoma

  Human chorionic gonadotropin is a hormone produced by the trophoblast and can be measured in both urine and blood. Elevated or rising human chorionic gonadotropin can be a sign of gestational choriocarcinoma, though it is also used as a biomarker in other types of gestational trophoblastic diseases (GTD). It is useful not only for diagnosis but also for monitoring disease progression, treatment response, and potential of recurring gestational choriocarcinoma. […] Common characteristic manifestations of gestational choriocarcinoma include irregular vaginal bleeding and hydatidiform moles. A hydatidiform mole is a red hemorrhagic mass with various sizes in the uterus. Often, diagnosis is presumptive. It is based on clinical findings and the identification of a malignant trophoblast. One prevalent symptom is vaginal bleeding after a pregnancy, abortion, or hydatidiform mole.

• #2 Persistent gestational trophoblastic disease following ovarian molar pregnancy: A case report of a rare entity with review of the literature

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8405531/

  The persistence of GTD is defined as a persistent elevation of hCG, and the condition is also known as gestational trophoblastic neoplasia (GTN). GTN generally is symptomless, and hence, the diagnosis is made by regular hCG surveillance. […] With the improvement in management approach, regular followup protocols, and the use of human chorionic gonadotropin as a biomarker, overall cure rates can exceed 98% with fertility retention. Frequent monitoring of hCG for at least 12 months with reliable contraception is essential for the surveillance of relapse. […] Careful followup with hCG surveillance is required to identify progression to persistent GTD. Despite the need for a long course of treatment, persistent GTD can be successfully by chemotherapy.

• #2 Gestational Trophoblastic Disease | Vanderbilt-Ingram Cancer Center

  https://vicc.org/cancer-info/adult-gestational-trophoblastic-disease

  Gestational trophoblastic disease (GTD) is a group of rare diseases in which abnormal trophoblast cells grow inside the uterus after conception. […] Signs of GTD include abnormal vaginal bleeding and a uterus that is larger than normal. […] A choriocarcinoma is a malignant tumor that forms from trophoblast cells and spreads to the muscle layer of the uterus and nearby blood vessels. It may also spread to other parts of the body, such as the brain, lungs, liver, kidney, spleen, intestines, pelvis, or vagina. […] These and other signs and symptoms may be caused by gestational trophoblastic disease or by other conditions. […] GTD sometimes causes an overactive thyroid. Signs and symptoms of an overactive thyroid include the following: Fast or irregular heartbeat, shakiness, sweating, frequent bowel movements, trouble sleeping, feeling anxious or irritable, weight loss.

• #2 Gestational Trophoblastic Disease – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/gestational-trophoblastic-disease

  Gestational trophoblastic disease is proliferation of trophoblastic tissue in pregnant or recently pregnant women. Manifestations may include excessive uterine enlargement, vomiting, vaginal bleeding, and preeclampsia, which usually manifest during early pregnancy. […] Choriocarcinoma usually manifests with symptoms due to lung, liver, or brain metastases. […] Invasive mole and choriocarcinoma are suspected if biopsy findings suggest invasive disease or if beta-hCG levels remain higher than expected after treatment for hydatidiform mole. […] In metastatic disease, the World Health Organization (WHO) prognostic scoring system for metastatic gestational trophoblastic disease can help predict prognosis, including risk of death. […] Poor prognosis is also suggested by the following (National Institutes of Health [NIH] criteria): Urinary hCG excretion 100,000 IU in 24 hours, Duration of disease 4 months (interval since prior pregnancy), Brain or liver metastases, Disease after full-term pregnancy, Serum hCG 40,000 mIU/mL, Unsuccessful prior chemotherapy, WHO score 6.

• #2 Choriocarcinoma: Types, Symptoms, Prognosis, and More

  https://www.verywellhealth.com/choriocarcinoma-overview-and-more-5200756

  Those who are diagnosed with choriocarcinoma have an 87.5% chance of achieving remission. Many will be able to successfully conceive after a full recovery from treatment. However, in some people, choriocarcinoma may return within a few months to three years of treatment. […] Potential complications that may impact the prognosis include: spreading of the cancer to other parts of the body (metastasis), especially to the liver or the brain.

• #2 Choriocarcinoma: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/24863-choriocarcinoma

  Choriocarcinomas happen when cells that form the placenta (called trophoblasts) become cancerous. […] It spreads quickly and is considered an aggressive type of cancer. […] Because this type of cancer spreads quickly, not getting treatment for choriocarcinoma can be fatal. […] Yes, choriocarcinoma is curable. Treatment with chemotherapy is usually successful in curing it. […] The prognosis is better when choriocarcinoma is caught early, before it spreads to other parts of your body. […] Non-gestational choriocarcinoma (not related to a prior abnormal pregnancy/placental tissue) has a worse prognosis and is less chemosensitive, which means chemotherapy may not be as effective in killing the cancer cells.

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