Choriocarcinoma

Definition

Malignant tumor of the ovary with trophoblastic differentiation composed of syncytiotrophoblast, cytotrophoblast and intermediate trophoblast.

Clinical Features

Exceedingly rare
May be associated with mature cystic teratoma of contralateral ovary1

Pathogenesis

Can develop:
- from ovarian pregnancy:
  - i.e. gestational
  - most common
- as form of germ cell neoplasm:
  - i.e. nongestational2
  - may be:
    - pure
    - more frequently, component of a mixed germ cell tumor

Histopathology

Typical admixture of syncytial and cytotrophoblastic elements in a necrotic and hemorrhagic background

Special Stains and Immunohistochemistry

Usually immunohistochemical reactivity for hCG
Keratin 7 said to represent a marker for subset of trophoblastic cells3
LK26 (a folate-binding protein):
- consistently expressed
- also in other ovarian malignancies4

Differential Diagnosis

Select up to 2 differential diagnoses to compare with Choriocarcinoma

Distinguish from exceptionally rare ovarian carcinomas of surface epithelial origin exhibiting choriocarcinomatous differentiation5

Prognosis

Nongestational choriocarcinoma:
- has worse prognosis than gestational6
- pure form often lethal
- good survival rates for mixed types7

References

1 Goswami D, Sharma K, Zutshi V, Tempe A, Nigam S. Nongestational pure ovarian choriocarcinoma with contralateral teratoma. Gynecol Oncol. 2001;80:262–266.

2 Gerbie MV, Brewer JI, Tamini H. Primary choriocarcinoma of the ovary. Obstet Gynecol. 1975;46:720–723.

3 Damjanov I, Osborn M, Miettinen M. Keratin 7 is a marker for a subset of trophoblastic cells in human germ cell tumors. Arch Pathol Lab Med. 1990;114:81–83.

4 Garin-Chesa P, Campbell I, Saigo PE, Lewis JL, Old LJ, Rettig WJ. Trophoblast and ovarian cancer antigen LK26. Sensitivity and specificity in immunopathology and molecular identification as a folate-binding protein. Am J Pathol. 1993;142:557–567.

5 Oliva E, Andrada E, Pezzica E, Prat J. Ovarian carcinomas with choriocarcinomatous differentiation. Cancer. 1993;72:2441–2446.

6 Vance RP, Geisinger KR. Pure nongestational choriocarcinoma of the ovary. Report of a case. Cancer. 1985;56:2321–2325.

7 Axe SR, Klein VR, Woodruff JD. Choriocarcinoma of the ovary. Obstet Gynecol. 1985;66:111–114.

Last updated: 24 Mar 2006