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Endocrine tumors in pregnancy
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Gestational choriocarcinoma develops from abnormal trophoblastic cells, which undergo hyperplasia and anaplasia with resulting malignant transformation. This occurs most frequently following a molar pregnancy, abortion, or normal pregnancy (in order of frequency).12,14
Gestational trophoblastic disease
Published in T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng, Richard Wing-Cheuk Wong, Hao Chen, Diagnostic Endometrial Pathology, 2019
T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng
Choriocarcinoma is a malignant trophoblastic neoplasm characterised by tumor cells resembling all three types of trophoblastic cells (cytotrophoblasts, syncytiotrophoblasts and intermediate trophoblasts),57 which display overtly malignant nuclear features. Choriocarcinoma may be gestational or non-gestational, depending on whether the tumor develops from pregnancy. Non-gestational choriocarcinoma is rare and generally of germ cell origin, which is much less chemosensitive and has a poorer prognosis.58 Gestational choriocarcinoma, in contrast, has a favorable response to chemotherapy.58 The following description will focus on gestational choriocarcinoma only.
Disseminated Primary Pulmonary Choriocarcinoma Successfully Treated by Chemotherapy: A Case Report and Literature Review
Published in Cancer Investigation, 2020
Ji-Hye Kim, Min-Jae Cha, Mi-Kyung Kim, Yun Jae Chung, Eun-Ju Lee
Although there is no standardized treatment for PPC, surgical resection or chemotherapy should be considered depending on the case. Patients who received surgery with/without chemotherapy were diagnosed postoperatively. Nine patients were successfully treated with surgery only because they had relatively smaller (5–55 mm) single nodules in their unilateral lungs; thus, the lesion might have been resected before dissemination. If PPC in these patients was detected preoperatively, chemotherapy might have been chosen as the treatment modality because choriocarcinoma is a chemo-sensitive tumor. This has been proven by experience from treating gestational choriocarcinoma and the lack of a difference between gestational and nongestational disease. Accordingly, 16 patients diagnosed with biopsy before operation received chemotherapy as the primary method of treatment (1,2,5,11,18,23,24,26,36,39,46,48,53,55). Another reason that chemotherapy might be considered the first choice in treating of PPC is the aggressive nature of the disease. A delay in initiation of chemotherapy due to surgery might allow time for dissemination. If the diagnosis is made after surgery, immediate postoperative chemotherapy is imperative. A combination of three to five chemoagents with cisplatin, etoposide, methotrexate, actinomycin D, vincristine, bleomycin, and cyclophosphamide is effective for PPC.
Advances in current and emerging therapeutics for gestational trophoblast malignancies
Published in Expert Opinion on Orphan Drugs, 2019
In contrast to the variable natural history of molar pregnancies, gestational choriocarcinoma is usually an aggressive malignancy and metastasizes frequently to the lungs, liver and central nervous system (CNS) [13]. The term “choriocarcinoma” is a pathological and clinical descriptive term, and although this aggressive malignancy can arise from a previous molar pregnancy, the majority of cases of high-risk and nearly all ultra-risk GTN are of nonmolar choriocarcinoma arising from the cells of an otherwise normal healthy conception. From the pathological appearances, malignant choriocarcinoma cells appear very similar to normal early trophoblast cells [14].
Current chemotherapeutic options for the treatment of gestational trophoblastic disease
Published in Expert Opinion on Pharmacotherapy, 2023
Antonio Braga, Gabriela Paiva, Cassia Juliana Cattai, Kevin M. Elias, Neil S. Horowitz, Ross S. Berkowitz
Although trophoblastic lesions may occur outside of pregnancy, characterizing non-gestational choriocarcinomas, these germ cell tumors, which can affect both women and men, will not be addressed here. However, it is worth noting that its prognosis is worse than that observed among patients with gestational choriocarcinoma, as they often progress with chemoresistance and relapse, even after surgery to remove the tumor.