Choriocarcinoma of the uterus
Clinical story
29 years old female with persistent bleeding following a miscarriage. Curettage showed malignant trophoblastic proliferation. The patient was treated with chemotherapy for four months, but a relapse was detected after three months. As a result, the uterus was removed. Grossly, a well demarcated hemorrhagic and necrotic tumor was seen in the isthmus.
Comments
The section is from the tumor with its relation to the cervical wall. A highly atypical, infiltrating tumor with hemorrhages and necroses is seen. The tumor consists of sheets of trophoblastic cells with one to several nucleoli and well-demarcated cell borders, and scattered, larger syncytial cells with several nuclei and a relatively acidophilic cytoplasm. Mitotic figures are numerous, and some are atypical.
Learning goals
To recognize the high grade of atypia and proliferative activity of choriocarcinomas, know about the etiology and risk factors.