Ovary tumor
Germ cell tumors
Choriocarcinoma


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

Revised: 2 June 2016, last major update October 2013

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Choriocarcinoma ovary
Cite this page: Choriocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/ovarytumorchorio.html. Accessed December 4th, 2016.
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
Epidemiology
  • 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
Laboratory
  • 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
Treatment
  • Surgery, chemotherapy
Gross Description
  • Hemorrhagic, soft, tan with necrosis
Gross Images

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Hemorrhagic mass

Ovarian mass

TAHBSO specimen

Micro 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
Micro Images

Images hosted on PathOut server:

Plexiform pattern



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H&E stain

Atypical syncytio
cytotrophoblast

β hcG+

Positive Stains
  • Cytokeratin, CD10, human placental lactogen, EMA
  • Syncytiotrophoblasts are hCG+
Negative Stains
Molecular / Cytogenetics Description
Differential Diagnosis