Ovarian Choriocarcinoma Arising From Partial Mole as Evidenced by Deoxyribonucleic Acid Microsatellite Analysis

Article · December 2003with6 Reads
DOI: 10.1016/S0029-7844(03)00224-2 · Source: PubMed
Recent developments in genetic analysis allow determination of the origin of choriocarcinoma (ie, gestational or nongestational), which helps determine the strategy for clinical treatment of the disease. We present a case of ovarian choriocarcinoma forming a huge ovarian mass 40 days after the patient's last menstrual period. Deoxyribonucleic acid microsatellite analysis of the tumor revealed that it contained a single maternal and two paternal alleles at several independent loci, consistent with the tumor resulting from ovarian pregnancy of a partial hydatidiform mole. This is the first description of an ovarian pregnancy of a partial hydatidiform mole-derived ovarian choriocarcinoma.
  • [Show abstract] [Hide abstract] ABSTRACT: Gestational and non-gestational choriocarcinomas have distinctly different tissues of origin, parental genotypes, natural histories, and responses to therapy. Our objective was to develop a convenient, fast, and reliable assay that would, using only patient tissue, allow separation of gestational from non-gestational choriocarcinomas. Benign and malignant tissues, preserved in paraffin blocks and separated by microdissection, were examined using a commercial PCR-based tissue identity assay (ABI AmpFlSTR Profiler Plus Kit and ABI 377 DNA sequencer) to detect genetic profiles of 9 microsatellite markers, along with X and Y chromosome markers. Cases included 6 choriocarcinomas. Controls included eight non-germ cell reproductive tract tumors and two hydatidiform moles. The microsatellite markers identified the five choriocarcinomas diagnosed on clinical and histological grounds as gestational, to be of genetically non-maternal (androgenic) origin. The neoplasm previously classified as a non-gestational choriocarcinoma was demonstrated to be of maternal origin, as were the non-germ cell reproductive tract tumors. Samples from hydatidiform moles contained either androgenic markers only or a mix of maternal and androgenic markers, as previously seen in complete and partial moles, respectively. A commercially available microsatellite DNA diagnostic assay is a quick and convenient way to discriminate between gestational and non-gestational choriocarcinoma.
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  • [Show abstract] [Hide abstract] ABSTRACT: This article reports a uterine gestational choriocarcinoma arising in a 57-year-old woman with a long latent period of 22 years from the last known pregnancy. Diagnosis was made on an endometrial biopsy specimen, and given the age of the patient, the long latent period, and the limited sample, trophoblastic differentiation within an endometrial carcinoma was considered. The results of DNA polymorphism studies illustrated both paternal and maternal alleles within the tumor in equal amounts, confirming the neoplasm to be gestational in origin and to have originated from a nonmolar gestation. The report discusses the value of DNA polymorphism studies in distinguishing gestational from nongestational choriocarcinoma and from trophoblastic differentiation within a carcinoma.
    Article · May 2008
  • [Show abstract] [Hide abstract] ABSTRACT: Tubal choriocarcinoma is an extremely rare condition and can be of gestational or non-gestational origin. The appropriate management of choriocarcinoma begins with the categorization of the tumor. However, it is difficult to discriminate the two types by routine histological examination. We report the first case of gestational choriocarcinoma of the Fallopian tube to be confirmed by a combination of p57(KIP2) immunostaining and DNA polymorphism analysis at 15 short tandem repeat loci, along with X and Y chromosome markers. The patient had no detectable metastasis or evidence of recurrence 15 months after treatment, which involved surgery without adjuvant chemotherapy. This case demonstrates the usefulness of a combination of p57(KIP2) immunostaining and DNA polymorphism analysis in determining the origin of extrauterine choriocarcinoma (i.e. gestational or non-gestational), which helps to determine the strategy for treatment of the disease.
    Full-text · Article · May 2011
  • [Show abstract] [Hide abstract] ABSTRACT: Pure ovarian choriocarcinomas are extremely rare and aggressive tumors which are gestational or non-gestational in origin. Due to the rarity of the tumor, there is a lack of information on the clinicopathologic features, diagnosis, and treatment. We report a case of a pure ovarian choriocarcinoma, likely of non-gestational origin, treated by cytoreductive surgery in combination with post-operative chemotherapy. The patient was free of disease after a 12-month follow-up. © 2011. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology and Colposcopy.
    Full-text · Article · Jun 2011