Article Text

Download PDFPDF
The Clinical Characteristics and Early Detection of Postpartum Choriocarcinoma
  1. Noriko Ryu, MD*,
  2. Masaki Ogawa, PhD, MD*,
  3. Hideo Matsui, PhD, MD*,
  4. Hirokazu Usui, PhD, MD and
  5. Makio Shozu, PhD, MD
  1. *Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, Tokyo; and
  2. Department of Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
  1. Address correspondence and reprint requests to Hideo Matsui, MD, Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinnjuku-ku, Tokyo, 162-8666, Japan. E-mail: matsui.hideo@twmu.ac.jp.

Abstract

Objectives This study aimed to identify the clinical and demographic characteristics and prognosis of patients with conditions diagnosed with postpartum choriocarcinoma based on the International Federation of Gynecology and Obstetrics 2000 prognosis scoring system or based on pathologically confirmed choriocarcinoma and to analyze the patients’ clinical symptoms for early detection of this disease.

Methods/Materials Between January 1983 and August 2013, 24 consecutive women with postpartum choriocarcinoma were treated at 2 hospitals. Data on clinical and demographic characteristics, including initial presenting symptoms, type of antecedent pregnancy, fetal complications, and prognosis of these patients, were analyzed. According to the time interval between the previous delivery and the onset of disease, patients were divided into 2 groups: the short and long interval groups.

Results The most common symptom among the 24 patients with postpartum choriocarcinoma was irregular vaginal bleeding (14/24); in some cases, bleeding was caused by metastatic foci (7/24). Massive genital bleeding causing emergency hysterectomy and several obstetric complications, such as unknown severe fetal anemia and fetal growth retardation, was only observed in the short interval group. The overall primary remission rate was 91.7%.

Conclusions The most common symptom of patients with postpartum choriocarcinoma in the short and long interval groups was genital bleeding, and the overall prognosis may be improved by introduction of an appropriate chemotherapy regimen. Careful pathological examination of the placenta is needed in cases of fetomaternal hemorrhage, unknown fetal anemia, and abnormal obstetric events, including premature delivery, still birth, and infantile growth retardation, for the early detection of intraplacental choriocarcinoma.

  • Postpartum choriocarcinoma
  • Intraplacental choriocarcinoma
  • Initial presenting symptoms
  • Prognosis

Statistics from Altmetric.com

Footnotes

  • The authors declare no conflicts of interest.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.