Trophoblastic vasculogenic mimicry in gestational choriocarcinoma

Abstract

Angiogenesis is a characteristic feature of solid tumors, which depend on the newly formed vasculature to prevent hypoxia and to sustain uncontrolled tumor cell proliferation. In this study, we investigated the blood supply system in 10 gestational choriocarcinomas on the basis of histopathological and immunohistochemical features. In all examined cases, morphological analysis demonstrated that blood channels within the center of choriocarcinomas were surrounded by neoplastic trophoblastic cells rather than by endothelial cells. Similarly, there was a lack of CD31 and CD34-positive endothelial cells within choriocarcinomas. In the periphery of choriocarcinomas, tumor cells invaded uterine stroma-derived blood vessels where trophoblastic cells replaced endothelial cells, forming anastomoses between endothelium-lined blood vessels and trophoblastlined pseudovascular channels. Masson's trichrome staining revealed minimal amounts of connective tissue within choriocarcinomas. In contrast, CD31 and CD34-positive blood vessels were present in other types of gestational trophoblastic neoplasms including 8 placental site trophoblastic tumors and 12 epithelioid trophoblastic tumors. These findings provide cogent evidence that choriocarcinoma represents one of a few human tumor types that utilizes vasculogenic mimicry by tumor cell in supporting tumor development.

Antagonism of EG-VEGF Receptors as Targeted Therapy for Choriocarcinoma Progression In Vitro and In Vivo

“…Previous studies reported the development of animal models of CC, mainly through subcutaneous injection of JEG3 cells (47). JEG3 dissemination and colonization of blood vessels were compared with non-trophoblastic tumor cells (48,49). Nevertheless, these studies were performed in non-gravid mice and cells were not injected orthotopically within the primary site of CC development, for example, the placenta.…”

Primary hepatic choriocarcinoma in an 83‐year‐old woman

“…Shih showed that pseudovascular choriocarcinoma networks are established by CD31‐negative syncytiotrophoblasts, not endothelial cells . In addition, he suggested that this phenomenon may cause massive hemorrhage and necrosis, which are frequently observed in choriocarcinoma.…”

“…Shih showed that pseudovascular choriocarcinoma networks are established by CD31-negative syncytiotrophoblasts, not endothelial cells. 13 In addition, he suggested that this phenomenon may cause massive hemorrhage and necrosis, which are frequently observed in choriocarcinoma. However, syncytiotrophoblast-and cytotrophoblast-like cells were both focally positive for the endothelial cell marker CD31 in the present case and one previous case.…”

Uterine artery pulsatility index: a predictor of methotrexate resistance in gestational trophoblastic neoplasia

“…In an ongoing study, we are assessing a panel of known circulating angiogenesis factors and correlating these with the UAPI to establish drivers of angiogenesis, and with MTX-R as alternatives to UAPI. Interestingly, in a recent study Shih Ie (2011) has shown that choriocarcinomas despite their apparent vascularity, lack endothelial-lined intra-tumoural blood vessels, and instead exhibit vascular mimicry. Consequently, it is plausable that the biological drivers of this may be distinct from classical angiogenic factors (Shih Ie, 2011).…”

“…Interestingly, in a recent study Shih Ie (2011) has shown that choriocarcinomas despite their apparent vascularity, lack endothelial-lined intra-tumoural blood vessels, and instead exhibit vascular mimicry. Consequently, it is plausable that the biological drivers of this may be distinct from classical angiogenic factors (Shih Ie, 2011). In the current study, only three patients had choriocarcinomas.…”