Chorionepithelioma

Abstract

Forty-one cases of chorionepithelioma were encountered during a period of eight and a half years, from July, 1953, to December, 1961, at the Department of Obstetrics and Gynaecology, Hong Kong University. In the same period 54,555 deliveries were undertaken by the same unit. The incidence of chorionepithelioma was thus one in 1,331 deliveries. The average age of the patients is 32.1 years and the average number of previous pregnancies 4.85. The majority (43.9%) were preceded by a mole, 29.3% by an abortion, 24.4% by a delivery, and 2.4% by an ectopic pregnancy. The time interval between the last pregnancy and the diagnosis of chorionepithelioma varied between two weeks and four years. Vaginal bleeding, continuous or irregular, was the commonest symptom, and the uterus was enlarged in more than two-thirds of the cases. The male frog test was positive in 37 cases and pulmonary secondaries, as revealed by radiological examination of the chest, were found in 29 cases. The usefulness and danger of curettage are briefly discussed, and common post-mortem findings are given. No treatment was given in seven cases, radium application alone to one case, testosterone alone to another, and methotrexate alone to two. The case of tubal chorionepithelioma was treated by salpingectomy. Hysterectomy with or without removal of the appendages, which was performed in 29 cases, was the commonest form of therapy. It was the sole form of treatment in 13, was combined with radiotherapy in six, and was used in association with methotrexate in 10. From an analysis of the results methotrexate appears to be a useful adjunct in the treatment of chorionepithelioma. A review of the literature in regard to the various forms of treatment of chorionepithelioma is included. I thank Professor Daphne W. C. Chun for her advice and for permission to compile the report. © 1962, British Medical Journal Publishing Group. All rights reserved.