Introduction/Background Gestational trophoblastic disease (GTD) encompasses a spectrum of disorders characterized by abnormal trophoblast development following anomalous fertilization. Choriocarcinoma is a rare yet potentially aggressive cancer due to its rapid spread. After confirming a gestational trophoblastic neoplasia (GTN) diagnosis, disease staging is essential based on clinical, laboratory, and complementary imaging findings to rule out distant disease according to the FIGO/WHO system. Based on this staging, the most appropriate treatment is determined.

Methodology The objective is to analyze the prevalence of choriocarcinoma in patients diagnosed with GTD at our center over the past 10 years. A retrospective, single-center observational study was conducted on patients diagnosed with GTD between 2013 and 2023. Data were collected from the patients‘ medical records.

Results In this cohort, fifteen patients received diagnoses of GTD. The median age was 34.67 years and they presented with a mean beta-human chorionic gonadotropin (β-hCG) blood level of 112,963.2 at diagnosis. Histopathological evaluation revealed complete hydatidiform moles in 53.33% of cases, partial moles in 33.33%, and choriocarcinoma in 13.33%. Among patients with complete moles, 37.5% progressed to persistent GTD, necessitating chemotherapy, to which they responded well. In the choriocarcinoma subgroup, one patient exhibited pulmonary metastases, currently in remission post-chemotherapy, while another succumbed to disease recurrence with cerebral and vaginal vault metastases (figure 1). The average total number of chemotherapy cycles per patient was 4.67.

Conclusion GTD represents an infrequent clinical challenge, underscored by the identification of 15 cases at our institution over the past decade. While the prognosis is predominantly favorable with successful therapeutic interventions, the potential for aggressive neoplasms requiring intensive chemotherapeutic management remains. Early diagnosis, diligent monitoring, and risk stratification are imperative for optimizing patient outcomes. These findings underscore an exigent need for further research to elucidate the pathophysiology and optimize the management of GTD, specially GTN like choriocarcinomas.

Disclosures All of the authors declare that there are no conflicts of interest.

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Abstract 408 Figure 1

PET scan and CT scan of the choriocarcinoma patients exhibiting pulmonary and cerebral metastasis