Choriocarcinoma is histologically and clinically overtly malignant and presents the most frequent emergency medical problems in the management of trophoblast disease. The diagnosis most frequently follows a CM [50%], when the patients are usually in a surveillance programme but can also arise in unsupervised patients after a non-molar abortion [25%] or term pregnancy [25%]. The clinical presentation of choriocarcinoma can be from the disease locally in the uterus leading to bleeding, or from distant metastases that can cause a wide variety of symptoms with the lungs, central nervous system and liver the most frequent sites of distant disease.

The cases of choriocarcinoma presenting with symptoms from distant metastases can be diagnostically challenging. However, the combination of the gynaecology history and elevated serum hCG usually makes the diagnosis clear and so avoid biopsy which can be hazardous due to the risk of haemorrhage.

On the occasions that pathology is available the characteristic findings show the structure of the villous trophoblast but sheets of syncytiotrophoblast or cytotro-phoblast cells, haemorrhage, necrosis and intravascular growth are common. The genetic profile of choriocarcinoma is a range of gross abnormalities without any specific characteristic patterns.

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