Trophoblastic diseases are mainly hydatidiform mole and choriocarcinoma, where the latter is usually the sequela of molar pregnancy and malignant systemic disease with general metastases destructing various tissues and organs till she die. High level urinary hCG, real-time B-mode and color Doppler imaging detect hydatidiform mole in early gestation, postmolar persistent trophoblastic disease is diagnosed by urinary hCG, and treated by prophylactic chemotherapy against choriocarcinoma. Uterine choriocarcinoma and its metastases are diagnosed by hCG and B-mode, color and power Doppler and 3D images detecting rich tumor blood flow. Most choriocarcinoma was effectively treated by primary chemotherapy with methotrexate, etoposide, etc. Until complete remission where hCG is lower than the cut-off level. Placental site trophoblastic tumor (PSTT) and epitheloid trophoblastic tumor (ETT) were low in hCG level and high in human placental lactogen (hPL), and show rich tumor blood flow in color Doppler ultrsound. Nongestational choriocarcinoma is rare and usually chemotherapy resistant.

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