What are the early symptoms of choriocarcinoma? The main difference between choriocarcinoma and invasive mole

Choriocarcinoma is a highly malignant tumor that occurs after hydatidiform mole, miscarriage or full-term delivery. Its incidence is about 0.0001% to 0.36%. A few cases may occur after ectopic pregnancy, mostly in women of childbearing age. The ovarian cancer that occasionally occurs in unmarried women is called primary choriocarcinoma. In the 1950s, the mortality rate was very high. In recent years, the application of chemotherapy has significantly improved the prognosis of choriocarcinoma. Choriocarcinoma mostly occurs in the uterus, but there are also cases where no primary lesions are found in the uterus and only metastatic lesions appear. Uterine choriocarcinoma can form single or multiple uterine wall tumors, which are dark red, purple or brown, with a diameter of 2 to 10 cm. They are hemorrhagic necrotic tissues. The tumor can protrude into the uterine cavity, invade the uterine wall or protrude from the serosal layer. It is brittle and very easy to bleed. Cancer thrombi are often found in the parauterine veins. The ovaries can form multicystic lutein cysts.

Choriocarcinoma is a malignant tumor that can cause the following common symptoms:

1. Female patients usually have hydatidiform mole or miscarriage, which leads to different degrees of continuous irregular vaginal bleeding. Generally, the disease occurs after the previous pregnancy. Female patients will have amenorrhea after normal menstruation, and then vaginal bleeding will occur again. Frequent and repeated bleeding is the most common. In the late stage, there will be heavy vaginal bleeding. Due to excessive bleeding, symptoms such as anemia and hemorrhagic shock will appear.

2. Physical signs: There will be a brown and very smelly vaginal discharge. During examination, the uterus is found to be abnormally enlarged and soft, and there are obvious pulses in the uterine arteries on both sides of the uterus.

3. Metastatic symptoms: The disease has metastasized to the lungs, liver, spleen, brain and other parts of the body, causing lung discomfort, and common symptoms such as hemoptysis, chest pain, and shortness of breath; metastasized to the brain, leading to serious hazards such as headaches, convulsions, coma, and hemiplegia; affected the liver and spleen, causing symptoms such as upper abdominal distension and splenomegaly.

4. HCG determination in blood or urine: the titer increases or HCG in blood or urine becomes positive after being negative.

5. X-ray lung film: Spherical shadows can be seen in the lungs, distributed in the lung fields on both sides. Sometimes there is only a single metastatic lesion, or several nodules merge into cotton balls or mass-like lesions.

6. Pathological diagnosis: Large areas of necrotic tissue and blood clots can be seen in the myometrium or other removed organs, surrounded by a large number of long, single, active trophoblastic cells, and no villous structure.

The vast majority of choriocarcinomas are related to pregnancy, occurring secondary to hydatidiform mole, miscarriage or normal delivery. There are also reports that it can occur directly from the fertilized egg, and even in rare cases from the trophoblastic components of the egg contained in the teratoma. It is extremely rare for it to occur in fallopian tube pregnancy or abdominal pregnancy.

Choriocarcinoma mostly occurs in the uterus, but there are also cases where no primary lesions are found in the uterus and only metastatic lesions appear. Uterine choriocarcinoma can form single or multiple uterine wall tumors, which are dark red, purple or brown, 2 to 10 cm in diameter, and are hemorrhagic necrotic tissues. The tumor can protrude into the uterine cavity, invade the uterine wall or protrude from the serosa. It is brittle and easily bleeds. Cancer thrombi are often found in the parauterine veins, and multicystic lutein cysts can form in the ovaries.

Histologically, choriocarcinoma is very different from general cancers. Choriocarcinoma does not have the inherent connective tissue stromal cells of general cancers, but only has trophoblasts, necrotic foci composed of blood clots and coagulative necrotic tissue, and no inherent blood vessels. Cancer cells directly contact the host's blood to obtain nutrition. Cancer cells are often not found in the center of the cancer. The closer to the edge, the more obvious the tumor cells are, but no villous structure can be seen, only clusters of trophoblasts.

main reason:

1. Pregnancy: Choriocarcinoma is common in women of childbearing age, usually after full-term delivery, hydatidiform mole, or miscarriage. Choriocarcinoma can be produced directly from the fertilized egg and then develop.

2. Viral and bacterial infections. Some experts believe that it is related to viral infection, but this has not been further proven.

3. It is related to multiple births and consanguineous marriage, and the incidence rate is much higher than that of ordinary patients.

1. Carry out extensive eugenics and family planning knowledge popularization, do a good job in contraception, reduce the chance of pregnancy, promote civilized sex life, prevent the spread of sexually transmitted diseases, and send tissue for pathology after abortion.

2. After choriocarcinoma is cured recently, consolidation chemotherapy should be performed for 1 to 3 courses. Blood β-HCG should be measured once a week thereafter. If the patient is normal, consolidation chemotherapy should be performed again after 3 months. Thereafter, chemotherapy should be performed once every six months. No further chemotherapy should be performed for those who have no recurrence within 2 years.

3. After choriocarcinoma is cured, women who desire to have children should strictly observe contraception for 2 years. To prevent the β-HCG value from being affected by contraceptive factors, it is best to adopt the twin contraceptive method of male condoms and female vaginal diaphragms.

4. According to current literature reports, the chance of malignant transformation of benign trophoblastic tumors is approximately 10% to 20%, so follow-up should be continued for at least 2 years, and long-term follow-up should be conducted if conditions permit.

1. Chemotherapy

Chemotherapy is the primary treatment for choriocarcinoma. It can be administered orally, intravenously, or by arterial infusion. Combination drug therapy can be used, especially for patients with advanced or severe disease.

2. Radiation therapy

It mainly plays an auxiliary role and is suitable for patients who have difficulty in surgery or whose disease has not disappeared significantly after multiple courses of chemotherapy. Whole-brain irradiation can be performed for patients with brain metastases.

3. Surgical treatment

Surgical treatment can be used for patients who have not responded to chemotherapy, patients who have no desire to have children, and patients in critical situations such as uterine perforation and bleeding from intrahepatic metastases.

4. Treatment of metastasis

Patients with brain metastases require systemic chemotherapy and should pay attention to preventing various complications; vulvar bleeding should be controlled promptly and gauze strips can be used to apply pressure to stop bleeding.

1. The diet should be comprehensive and rich in variety, such as various proteins, fats, carbohydrates, various vitamins, minerals and trace elements, etc.

2. Eat more fresh vegetables and fruits, such as apples, oranges, pears, rapeseed, shepherd's purse, cabbage, carrots, etc.

3. Eat more foods that have anti-cancer effects, such as mushrooms, black fungus, garlic, seaweed and royal jelly.

4. Eat more foods that have anti-cancer effects, such as mushrooms, black fungus, garlic, seaweed and royal jelly.

1. Avoid foods that are difficult to digest, smoking, drinking, and other spicy and irritating foods.

2. Eat less hen meat and fried foods.

3. Do not eat mutton, shrimp, crab, eel, salted fish, black fish and other irritating foods.