Ovary tumor
Germ cell tumors

Authors: Leena Varughese, M.D. (see Authors page)
Editor: Rajit Malliah, M.D.

Revised: 24 October 2018, last major update October 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Choriocarcinoma ovary
Cite this page: Varughese, L. Choriocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorchorio.html. Accessed December 13th, 2018.
Definition / general
  • Rare primary ovarian tumor; < 1% of primitive ovarian germ cell tumors
  • May develop from ovarian pregnancy (gestational choriocarcinoma), as a germ cell tumor (pure or mixed, non-gestational choriocarcinoma) or as a surface epithelial tumor with choriocarcinomatous differentiation
  • Primary ovarian choriocarcinomas are more common in children and adolescents
  • After puberty, origin from an ovarian ectopic pregnancy cannot be excluded
Clinical features
  • Presentation similar to ectopic or tubal pregnancy
  • Abdominal enlargement
  • Pain, sometimes hemoperitoneum
  • Isosexual precocity, menstrual abnormalities, androgenic changes
  • Markedly elevated serum β hCG
  • Monitoring serum levels of β hCG is helpful in predicting recurrence and response to therapy
Radiology description
  • On imaging, appears as vascular solid tumor with cystic, hemorrhagic, necrotic areas
Prognostic factors
  • In contrast to gestational choriocarcinomas, non-gestational choriocarcinomas are difficult to treat, generally unresponsive to chemotherapy
  • Metastases to lungs, liver, bone and viscera are common at diagnosis
Case reports
  • Surgery, chemotherapy
Gross description
  • Hemorrhagic, soft, tan with necrosis
Gross images

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Hemorrhagic mass

Ovarian mass

TAHBSO specimen

Microscopic (histologic) description
  • Composed of cytotrophoblast, intermediate trophopblast and multinucleated syncytiotrophoblast around periphery of blood channels
  • Cytotrophoblasts have clearly defined cytoplasmic borders, are mononucleated with vesicular nuclei and distinct nucleolus
  • Syncytiotrophoblasts contain basophilic to amphophilic cytoplasm with mutiple nuclei
Microscopic (histologic) images

Images hosted on PathOut server:

Plexiform pattern

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H&E stain

Atypical syncytio

β hcG+

Positive stains
  • Cytokeratin, CD10, human placental lactogen, EMA
  • Syncytiotrophoblasts are hCG+
Negative stains
Molecular / cytogenetics description
Differential diagnosis