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[On interrupted postmolar choriocarcinoma]
It is extremely difficult to specify which pregnancy is responsible for gestational choriocarcinoma. Generally an antecedent pregnancy, directly preceding choriocarcinoma, is thought to be responsible for it. We have seen not a few cases of choriocarcinoma that had an obstetrical history of previous molar pregnancy preceding antecedent pregnancy. In such cases, responsibility not of the antecedent non-molar pregnancy but of the previous molar pregnancy is highly suspect in choriocarcinoma. In Niigata prefecture which has a population of 2.5 millions, we have reported 1,573 cases of total hydatidiform mole and 61 cases of choriocarcinoma in the past 12 years to the Regional Trophoblastic Disease Center. There were 8 cases of interrupted postmolar choriocarcinoma. The antecedent pregnancy was term delivery in 6 cases and abortion in 2 cases. It was of special interest to note that most of the interrupted postmolar choriocarcinoma were anteceded by term delivery with a previous history of hydatidiform mole. With the aid of statistics of pregnancy, delivery and trophoblastic disease in Niigata prefecture in the period of the survey, delivery with a previous history of hydatidiform mole was calculated to have 290 times as high risk of choriocarcinoma as that without a history of hydatidiform mole. Recently intraplacental choriocarcinoma with either living or, at times, stillborn baby has been reported occasionally. Most of the placenta reported in those cases showed no adverse effect on the growth of the fetus and no gross abnormality. Mostly intraplacental choriocarcinomatous lesion was detected incidentally or by minute histological examination of the placenta. From these results we emphasize the need to have a careful gross as well as microscopic examination of the placenta in case of a parturient with a previous history of hydatidiform mole and who has a higher risk for choriocarcinoma.
It is extremely difficult to specify which pregnancy is responsible for gestational choriocarcinoma. Generally an antecedent pregnancy, directly preceding choriocarcinoma, is thought to be responsible for it. We have seen not a few cases of choriocarcinoma that had an obstetrical history of previous molar pregnancy preceding antecedent pregnancy. In such cases, responsibility not of the antecedent non-molar pregnancy but of the previous molar pregnancy is highly suspect in choriocarcinoma. In Niigata prefecture which has a population of 2.5 millions, we have reported 1,573 cases of total hydatidiform mole and 61 cases of choriocarcinoma in the past 12 years to the Regional Trophoblastic Disease Center. There were 8 cases of interrupted postmolar choriocarcinoma. The antecedent pregnancy was term delivery in 6 cases and abortion in 2 cases. It was of special interest to note that most of the interrupted postmolar choriocarcinoma were anteceded by term delivery with a previous history of hydatidiform mole. With the aid of statistics of pregnancy, delivery and trophoblastic disease in Niigata prefecture in the period of the survey, delivery with a previous history of hydatidiform mole was calculated to have 290 times as high risk of choriocarcinoma as that without a history of hydatidiform mole. Recently intraplacental choriocarcinoma with either living or, at times, stillborn baby has been reported occasionally. Most of the placenta reported in those cases showed no adverse effect on the growth of the fetus and no gross abnormality. Mostly intraplacental choriocarcinomatous lesion was detected incidentally or by minute histological examination of the placenta. From these results we emphasize the need to have a careful gross as well as microscopic examination of the placenta in case of a parturient with a previous history of hydatidiform mole and who has a higher risk for choriocarcinoma.