Symptoms of Choriocarcinoma

Choriocarcinoma is a cancer that occurs during pregnancy. It is mainly caused by abnormalities in pregnancy, which leads to the development of tumors in the villi. This type of choriocarcinoma can cause hydatidiform mole in the fetus, which needs to be treated through abortion, and can cause symptoms of ectopic pregnancy. Choriocarcinoma is a disease that occurs in women of childbearing age. The probability of unmarried women developing choriocarcinoma is relatively low.

What is Choriocarcinoma

Choriocarcinoma is a gestational trophoblastic disease, a trophoblastic tumor secondary to normal or abnormal pregnancy, and is a highly malignant tumor. 50% of choriocarcinomas occur after a hydatidiform mole, 25% after a miscarriage, and 10% after a full-term delivery or ectopic pregnancy. This disease often occurs in women of childbearing age and occasionally in unmarried women and is called primary choriocarcinoma.

Symptoms of Choriocarcinoma

1. Vaginal bleeding: Bleeding occurs after uterine curettage of hydatidiform mole, after miscarriage, full-term delivery, or after ectopic pregnancy. It may occur from time to time and the amount of bleeding may vary. It may also be manifested as normal menstruation for a period of time, followed by amenorrhea, and then vaginal bleeding.

2. Abdominal mass: Due to the uneven enlargement of the uterus, patients often feel a mass in the lower abdomen.

3. Pregnancy-like symptoms appear: mainly referring to enlarged breasts, darker nipples and areolas, and softening of the vagina.

4. Local bleeding: If the disease metastasizes, the common feature of each metastatic site is local bleeding. The most common metastasis is lung metastasis, which may cause hemoptysis, followed by parametrial tissue and vaginal metastasis, and then brain metastasis.

5. When choriocarcinoma is combined with pregnancy, not only will heavy uterine bleeding occur during pregnancy, which is often misdiagnosed as placenta previa, but bleeding during delivery is also very severe, which is often misdiagnosed as placental abruption.

Choriocarcinoma screening methods

1. HCG measurement in blood or urine (human chorionic gonadotropin): the titer increases or HCG in blood or urine becomes positive after being negative.

2. X-ray examination: Spherical shadows can be seen in the lungs, distributed in the lung fields on both sides, and sometimes there is only a single metastatic lesion. Or several nodules fuse into a cotton ball, mass-like lesion.

3. Pathological diagnosis: Large areas of necrotic tissue and blood clots can be seen in the myometrium or other removed organs, surrounded by a large number of active trophoblasts, and no villous structure.

Diagnosis of choriocarcinoma

1. Irregular vaginal bleeding, hemoptysis, headache, vomiting, hemiplegia, etc. occur one year after hydatidiform mole curettage, delivery, miscarriage, or ectopic pregnancy.

2. Purple-blue metastatic nodules in the vagina.

3. Enlarged uterus and parauterine mass.

4. Ovarian lutein cyst.

5. Blood and urine hCG levels are higher than normal.

6. Chest X-ray shows multiple cotton-like shadows.

7. A space-occupying lesion was found in a skull X-ray.

8. Pathological examination revealed active trophoblastic proliferation and no villous structure.

9. The clinical staging is the same as that of invasive hydatidiform mole.