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Bleeding is one of the most common clinical presentations of this spectrum of disorders that includes hydatidiform mole, invasive mole, and choriocarcinoma.
66) At least some studies that include choriocarcinomas suggest an improved prognosis under current chemotherapeutic regimens.
21-22) The histologic classification of GCTs at this site is identical to that used in the gonads: seminomatous (pure), nonseminomatous (yolk sac tumor, embryonal carcinoma, choriocarcinoma, and mixed GCTs), and teratomas.
Invasive mole and choriocarcinoma might even follow such a pregnancy.
37,38) The giant tumor cells may stain immunohistochemically for human chorionic gonadotropin but should not be confused with a primary choriocarcinoma of the lung.
In this study, we measured plasma mRNA concentrations by real-time RT-PCR in 3 GTD patients with CHMs and 1 with choriocarcinoma.
68,69) Metastatic choriocarcinomas can be confirmed with positive staining for human chorionic gonadotropin.
Mono-, bi-, and biantennary N-linked sugars occur in hCG[beta] in both normal and abnormal pregnancies as well as in choriocarcinomas (12-17).
Selected immunohistochemical markers can also be helpful to distinguish the different germ cell-tumor elements: dysgerminomas reveal immunohistochemical expression of PLAP, OCT3/4 and c-kit; embryonal carcinomas show positivity for CD30, PLAP, a-fetoprotein, keratin, and human chorionic gonadotropin; yolk sac tumors are immunoreactive for a-fetoprotein, PLAP, alkaline phosphatase, and keratins; and choriocarcinomas show expression of human chorionic gonadotropin, cytokeratin, PLAP, and human placental lactogen.
GTD is a general term that includes benign and malignant conditions of hydatidiform mole (both complete and partial) as well as choriocarcinomas.
Almost all remaining choriocarcinomas arise in ectopic pregnancies, the gonads, or midline locations (mediastinum, retroperitoneum, and pineal gland) as a teratoma.
The phenomenon of large, postmitotic tumor cells has previously been noted in many benign and malignant tumors, especially in endocrine neoplasms, and is most common and striking in choriocarcinomas.