LAUSR

Choriocarcinoma is a malignant neoplasm that is classified as gestational and nongestational. Gestational choriocarcinoma is composed of cytotrophoblast, syncytiotrophoblast, and intermediate trophoblast. More than 50% are preceded by a complete mole, 25% by a spontaneous or induced abortion, 22.5% by a normal pregnancy, and 2.5% by an ectopic pregnancy. It occurs in utero and can metastasize to other organs. It may have an extrauterine origin; however, the patients are pregnant or have a history of pregnancy. 2 Nongestational choriocarcinoma is composed of cytotrophoblast and syncytiotrophoblast that is not gestational in origin. Most develop in the ovary; rarely, the primary origin is in the cervix, with fewer than 200 cases reported in the literature (Medline research: 1952 to 2021). In girls and young women nongestational choriocarcinoma originates from germ cells, and in older women it likely develops from epithelial neoplasia that contains foci of choriocarcinoma. 3 On scan magnification, attention should be drawn to the extensive hemorrhage and necrosis that often accompany this neoplasm (Figure 1A). The tumor consists of a mixture of mononuclear cytotrophoblast and multinucleated syncytiotrophoblast, hemorrhage and necrosis and these may mask tumor cells (Figure 1B). Cytotrophoblast cells are polygonal, epithelioid in appearance, and with precise cell boundaries. Their cytoplasms are eosinophilic, have a large single nucleus, and prominent nucleoli.