Chorangiocarcinoma of the placenta: A case report and clinical review

Faes, T.J.C.; Pecceu, A.; Calenbergh, S. Van; Moerman, Philippe

doi:10.1016/j.placenta.2012.04.012

Cited by 32 publications

(13 citation statements)

References 12 publications

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“…However, treatment of nonmetastatic disease is controversial. Some authors describe cases of success with only surveillance [1, 3, 8, 14, 15]. Some authors suggested that “patients with choriocarcinoma confined to the placenta with rapid decrease of serum hCG after the removal of the placenta do not need chemotherapy, but only fetal and maternal close follow-up” [16].…”

Section: Discussionmentioning

confidence: 99%

Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

Caldas

Oliveira

Rodrigues

et al. 2017

Case Reports in Medicine

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Intraplacental choriocarcinoma is a rare malignant tumor diagnosed after an abortion, an ectopic pregnancy, or a term or preterm pregnancy or following the diagnosis of a hydatidiform mole. During pregnancy, it may be more common than reported, as most patients are asymptomatic and placental choriocarcinomas are usually inconspicuous macroscopically and are often mistaken for an infarct. Based upon a case study methodology, we describe 2 cases of intraplacental choriocarcinoma: the first case was identified in the product of a uterine curettage following an incomplete miscarriage and the second in one of the placentas of a bichorionic twin pregnancy. Maternal investigation did not reveal evidence of metastatic disease and neither did the infants' one in the second case. The two cases underwent maternal surveillance with serum hCG and remained disease-free until the present. In conclusion, intraplacental choriocarcinoma is easily underdiagnosed but with current treatment, even in the presence of metastasis, the prognosis is excellent. A routine microscopic examination of all the placentas and products of miscarriage can increase the real incidence of this entity and consequently improve its management.

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Section: Discussionmentioning

confidence: 99%

Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

Caldas

Oliveira

Rodrigues

et al. 2017

Case Reports in Medicine

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“…The concentrations of human β‐chorion gonadotropin (β‐hCG) in serum increase in advanced stages of choriocarcinomas (Federation of Gynecology and Obstetrics; FIGO stages) and is useful for diagnosis and monitoring effects of chemotherapy on progression of choriocarcinomas (Stevens et al, ). Based on the FIGO score of choriocarcinoma patients, the first line treatment is defined as single agent systemic chemotherapy or a polychemotherapy regimen with etoposide, methotrexate and actinomycin D with cyclophosphamide plus vincristine (EMA‐CO) (Faes et al, ; Stevens et al, ). Although survival rates in women who are diagnosed with choriocarcinoma is greater than 90%, development of new therapeutic agents is crucial for enhancement of curative value and minimization of side effects of treatments for choriocarcinoma.…”

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confidence: 99%

Inhibitory Effects of Quercetin on Progression of Human Choriocarcinoma Cells Are Mediated Through PI3K/AKT and MAPK Signal Transduction Cascades

Lim

Yang

Park

et al. 2016

Journal Cellular Physiology

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As a major dietary flavonol, quercetin mitigates proliferation and progression of cancer due to its anti-angiogenic, anti-inflammatory, anti-oxidant, and apoptotic biological effects on cells. Although its apoptotic effects have been reported for various cancers, little is known of the functional role of quercetin in gestational choriocarcinoma. Results of the present study indicated that quercetin reduced proliferation and induced cell death in two choriocarcinoma cell lines, JAR and JEG3 cells, with an increase in the sub-G phase of the cell cycle. In addition, quercetin induced mitochondrial dysfunction significantly reduced mitochondrial membrane potential (MMP) and increased production of reactive oxygen species (ROS) in both JAR and JEG3 cells. Further, quercetin inhibited phosphorylation of AKT, P70S6K and S6 proteins whereas, it increased phosphorylation of ERK1/2, P38, JNK and P90RSK proteins in JAR and JEG3 cells. The decrease in viability of choriocarcinoma cells treated with quercetin was confirmed by using combinations of quercetin and pharmacological inhibitors of the PI3K and MAPK signaling pathways. Classical chemotherapeutic agents, cisplatin (a platinum-based drug) and paclitaxel (a taxene-based drug), inhibited proliferation of JAR and JEG3 cells, and when combined with quercetin, the antiproliferative effects of cisplatin and paclitaxel were enhanced for both choriocarcinoma cell lines. Collectively, these results suggest that quercetin prevents development of choriocarcinoma and may be a valuable therapeutic agent for treatment of choriocarcinoma through its regulation of PI3K and MAPK signal transduction pathways. J. Cell. Physiol. 232: 1428-1440, 2017. © 2016 Wiley Periodicals, Inc.

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“…Few cases of chorangiocarcinoma have been reported in literature. In all of the reported cases no malignant metastases were reported (43) . Confirmation of continuity of feeding vessels with the fetal circulation by Doppler ultrasound can exclude other pathological conditions like placental hemorrhage, maternal lakes, or degenerated myoma (16) .…”

Section: Differential Diagnosis Of Placental Tumorsmentioning

confidence: 99%

Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors?

et al. 2017

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Placental chorioangioma is the most common subtype of non-trophoblastic placental tumors. Other subtypes are very rare and usually associated with an uneventful course of pregnancy. Most chorioangiomas are small and of no clinical significance. Giant chorioangiomas may be associated with serious fetal and maternal complications. So far, no established ultrasound guidelines are available for the management of placental non-trophoblastic tumors. This may be attributed to the rarity of the disease entity and its different clinical features and complications. In this article, the role of ultrasound findings such as the tumor’s size, vascularity, feeding vessels, amniotic fluid and location of the placenta in the diagnosis, treatment and follow up of these tumors is presented relying on up-todate literature review. Conservative management with serial ultrasound examinations can be an adequate method for monitoring small uncomplicated tumors. Ultrasound-guided procedures such as amnioreduction and cordocentesis can be used for amelioration of complications. Chorioangioma-specific treatment is reserved for complicated cases in the second trimester of pregnancy when prematurity is a matter of concern. Endoscopic laser ablation is indicated when the feeding vessel is superficial and small. Interstitial laser ablation is helpful when the placenta is located in the anterior uterine wall. Ligation of the feeding vessels is preferred when they are large. Alcohol injection should be performed away from the vasculature to prevent toxicity. Microcoils should be inserted as near as possible to the tumor to prevent collateral formation. Ultrasound is also a method of choice for monitoring the effectiveness of these procedures.

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Chorangiocarcinoma of the placenta: A case report and clinical review

Cited by 32 publications

References 12 publications

Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

Intraplacental Choriocarcinoma: Rare or Underdiagnosed? Report of 2 Cases Diagnosed after an Incomplete Miscarriage and a Preterm Spontaneous Vaginal Delivery

Inhibitory Effects of Quercetin on Progression of Human Choriocarcinoma Cells Are Mediated Through PI3K/AKT and MAPK Signal Transduction Cascades

Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors?

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