Medical Presentations of Choriocarcinoma

Choriocarcinoma commonly presents with symptoms resulting from metastases in the lungs, central nervous system, or alimentary tract. This tumour may occur without any gynaecological symptoms and when pelvic examination and uterine curettage show no abnormality. Several years may elapse between the antecedent pregnancy and presentation with metastatic disease. The ability to eradicate these tumours with present chemotherapeutic methods depends on detecting their presence as soon as possible after the antecedent pregnancy. Wider recognition of the varied manifestations of metastatic choriocarcinoma and greater use of tests for chorionic gonadotrophin should result in earlier diagnosis and an improved prognosis in these patients. In particular, such tests should be made in patients with unexplained intracranial haemorrhage, progressive dyspnoea, and gastrointestinal haemorrhage.