Mann, 26 J. Orchiektomie
- Hoden mit Atrophie der erhaltenen Samenkanälchen (Tubulusatrophie)
- Invasiv-destruktiv wachsender, teils hämorrhagisch durchsetzter,
teils nekrotischer Tumor
- Platten und Stränge kubischer und synzytialer Zellen
- Tumorinfiltration in Blut- und Lymphgefässe
- Braunes Reaktionsprodukt in synzytialen Riesenzellen (synzytiale RZ)
Klinik:
- Schmerzlose Vergrösserung eines Hodens.
- Zunehmend erhöhte Serumwerte des Beta-hCG nachweisbar.
- Ausgedehnte Metastasierung in Lungen, Knochenmark, Hirn, Leber und
Nieren
- Spricht gut auf die heutige Chemotherapie an
Bei der Frau meistens Tumor der Plazenta oder des Ovars. Inzidenz
ca. 1:25'000 Schwangerschaften (USA) (ca. 50% Blasenmolen, 25% Aborte,
22% normale Schwangerschaften)
26-year-old male underwent orchiectomy.
- Circumscribed tumor with invasive and destructive growth pattern.
- Sheets and strands of mononuclear cuboidal cells with occasional multinucleated syncytiotrophoblastic cells in a necrotic background. Multinucleated syncytiotrophoblastic cells stain positive for hCG.
- Tumor infiltrates into lymph- and blood vessels.
- Apart from the tumor testicular atrophy (Tubulusatrophie).
- Brown bHCG staining seen in syncytiotrophoblastic giant cells (synzytiale RZ)
Clinical findings:
- Presentation with painless enlargement of the testis.
- Patients with choriocarcinoma always exhibit elevated serum levels of hCG.
- Extensive hematogenous metastasis into lung, liver, but also brain, kidneys and bone marrow.
- Choriocarcinomas respond well to chemotherapy.
In females non-gestational and gestational choriocarcinomas are distinguished. The latter are observed more frequently, the incidence being about 1:24000 pregnancies. Of those, roughly 50% are derived from
complete hydatidiform moles, around 25% follow normal pregnancies and another 25% spontaneous abortion.