Limits of therapy for malignant chorioepithelioma

Report on two cases of malignant chorio-epithelioma following hydatidiform mole, both decreased 4 years after inception of the disease despite initially successful therapy and repeated remissions. In the first case a solitary pulmonary metastasis showing obvious de-differentiation and extensive local reparative processes was removed operatively. Associations to cytostatic medication are discussed. The second case was characterized by unusually extensive chronic pulmonary embolism with highly regressive choriocardinomatous aggregates. Death resulted unexpectedly from chronic dextrocardial insufficiency. It is stressed that the treatment is subject ot limitations of not only relative (i.e., resistance to cytostatics, inadequate treatment etc.) but also of an absolute nature, as in case 2.