Chorionic epithelioma
| Classification according to ICD-10 | |
|---|---|
| C58 |
Malignant neoplasm of the placenta Chorionic epithelioma Chorionic carcinoma |
| C62 | Malignant neoplasm of the testicle |
| ICD-10 online (WHO version 2019) | |
The chorionic epithelioma (syn. Chorionic carcinoma ) is an infiltrative growing tumor from anaplastic trophoblast cells . In women of childbearing potential, the tumor often occurs after molar moles , less often after miscarriages , normal pregnancies and tubal pregnancies . Chorionic carcinoma is considered a very aggressive tumor and metastasizes early. Non-gestational chorionic carcinoma of the ovary is less common. This is a germ cell tumor that often occurs in childhood and adolescence.
Epidemiology
The ratio of chorionic cancer to births in America and Europe is approximately 1: 45,000.
The malignant tumor is often found after a first pregnancy, especially older Primapara ( first-time women over the age of 30) are affected.
About 50% of the cases occur after a molar , about 25% after a miscarriage or during or after a normal pregnancy .
Symptoms
The main symptom in chorionic carcinoma is cycle-independent, vaginal bleeding. If metastases are present, these can also cause symptoms.
Pathogenesis
The chorionic carcinoma often arises from a mole of the bladder . The probability of degeneration is 2–17%. An increased immune tolerance to paternal antigens is discussed as a further cause .
course
The chorionic carcinoma is one of the very aggressive carcinomas. It grows invasively and destructively into the myometrium . The eroded vessels lead to bleeding and haematogenic metastases, especially in the lungs, vagina, liver, kidneys and brain.
Staging
Depending on the degree of invasive growth and the presence of metastases, a distinction is made between the following entities :
- non-metastatic chorionic carcinoma
- destructive moles (with or without metastasis)
- metastatic chorionic carcinoma with low risk
- metastatic chorionic cancer with high risk
As high-risk cases are with a metastasis in the lung, pelvis, CNS or liver, or with an HCG -mirror greater than 100,000 IU .
therapy
The chorionic carcinoma responds very well to chemotherapy with methotrexate . Cure is possible even in the early stage of metastasis.
The therapy was developed in 1956 by Roy Hertz and Min Chiu Li at the National Cancer Institute, who succeeded in completely regressing a previously fatal cancer.
Chorionic carcinoma in men
The chorionic carcinoma can rarely also occur in men, then it is usually localized in the testes. See: Germ cell tumor .
literature
- Alex Novotny: Gynecology, Obstetrics and Neonatology: Textbook for Nursing Professions . W. Kohlhammer Verlag, 2006, ISBN 3-17-018346-X ( full text in the Google book search).
- Carlos Thomas: Special Pathology . Schattauer Verlag, 1996, ISBN 3-7945-1713-X ( full text in the Google book search).
- Klaus Diedrich , Wolfgang Holzgreve, Walter Jonat , Askan Schultze-Mosgau, Klaus-Theo M Schneider: Gynecology and Obstetrics . Springer Verlag, 2006, ISBN 3-540-32867-X ( full text in the Google book search).
Individual evidence
- ↑ T M. Ulbright: Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issus. In: Mod Pathol . 2005, Suppl 2, pp. 61-79.
- ↑ wjso.com