Introduction/Background Gestational trophoblastic disease encompasses a range of conditions exhibiting variations in regression, metastatic potential, and recurrence tendencies. Predominantly affecting women in their childbearing years, gestational trophoblastic tumors (GTT) represent the malignant forms of these conditions, often associated with molar pregnancies, particularly hydatidiform mole. Conducted over a 2-years and a half period at our institution, our study specifically delves into choriocarcinoma, a rare subtype within GTT known for its frequent occurrence of distant metastases. The objective of our study is to delineate clinical presentations, evaluate the application of imaging techniques for diagnosis, and engage in a discourse on the management of this condition.

Methodology A retrospective analysis was undertaken at our institution from January 1, 2021, to August 1, 2023, examining data from numerous patients admitted for the treatment of gestational trophoblastic tumors (GTT). The sole inclusion criterion was histological confirmation of choriocarcinoma, a rare subtype of GTT known for its propensity to cause distant metastases. Throughout the study duration, merely four instances of gestational choriocarcinoma were detected.

Results Three cases were associated with a hydatidiform mole, and one occurred subsequent to a normal delivery. The average age of the patients was 28 years, with all presenting symptoms of vaginal bleeding. Pulmonary metastases were observed in two of the patients. The primary diagnostic tools included ultrasound examination and measurement of human chorionic gonadotropin (hCG) levels. Histological confirmation of choriocarcinoma was achieved for all cases. Treatment involved polychemotherapy for two patients and monotherapy for one.

Conclusion A thorough understanding of these trophoblastic tumors and their characteristics allows for the proposal of more coherent therapeutic protocols. Given the rarity of this condition and the complexity of therapeutic protocols, the establishment of reference centers for registry development and consensus management of these tumors is strongly recommended.

Disclosures All the authors have no financial disclosure or conflicts of interest with the presented material in this presentation.