Choriocarcinoma Explained: Causes, Signs, and Medical Care

Pregnancy is a sensitive time for women’s well-being, and may often lead to health complications. Did you know that the primary cause of gestational choriocarcinoma, a rare, fast-growing cancer, stems during pregnancy. It occurs when cells from a pregnancy turn cancerous. While dangerous, choriocarcinoma is highly curable. This article will explain what this type of cancer is.

To get a better understanding of this, the editorial team of OnlyMyHealth reached out to Dr Mythili Kundur, Associate Consultant, Gynaecological Oncology, Aster CMI Hospital, Bangalore and Dr Niti Raizada, Principal Director – Medical Oncology & Haemato-Oncology, Fortis Hospitals, Bengaluru.

What Causes Choriocarcinoma?

Before we examine choriocarcinoma in detail, let us tell you what it is. Dr Kundur explains, “Choriocarcinoma is a rare cancer that starts from cells that normally form the placenta during pregnancy. It is usually caused by an abnormal pregnancy, most commonly a molar pregnancy, where the fertilised egg grows unusually. It can also develop after a miscarriage, abortion, ectopic pregnancy, or even a normal delivery. The main cause is the uncontrolled growth of trophoblast cells, which are meant to support the baby. These cells grow rapidly and spread easily through the blood to other parts of the body, such as the lungs or the brain.”

Adding to this, Dr Raizada said, “Choriocarcinoma arises from trophoblastic tissue, which normally forms part of the placenta during pregnancy. It most commonly develops after a molar pregnancy, but can also occur following a normal pregnancy, miscarriage, or ectopic pregnancy. The exact cause is not always clear, but it is linked to abnormal growth of placental cells that become malignant.”

Is Choriocarcinoma Always Related to Pregnancy?

Choriocarcinoma is not always related to pregnancy, but is often associated with it for a reason. According to the Cleveland Clinic, gestational choriocarcinoma is more common. It refers to cancer that develops during or shortly after pregnancy. This cancer is most common in women who have a molar pregnancy (when the sperm and egg join incorrectly and form a hydatidiform mole). It can also occur after an ectopic pregnancy (it is a type of pregnancy that ends in miscarriage or even after a full-term pregnancy resulting in a birth). However, there is also another type called non-gestational choriocarcinoma that affects all sexes. It’s a type of germ cell tumour that can impact the ovaries or uterine lining, but is not linked to the placenta. In men, it can develop in the testicles.

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What are the Symptoms of Choriocarcinoma?

Let us now take a look at the symptoms of choriocarcinoma. Dr Kundur lists them for us: 

• Abnormal vaginal bleeding, which may happen after a pregnancy, miscarriage, or abortion, may be heavy or irregular.
• Some women may have pelvic pain or swelling in the uterus.
• Since this cancer spreads quickly through the blood, it can cause symptoms in other parts of the body, such as cough, chest pain, or breathlessness, if it reaches the lungs.
• Headache, dizziness, or seizures, if it affects the brain.
• Other signs include extreme tiredness, nausea, and high levels of pregnancy hormone human chorionic gonadotropin (hCG), even when not pregnant.

Regarding this, Dr Raizada says, “The symptoms can vary, but the most common sign is irregular or heavy vaginal bleeding after pregnancy. Some women may also experience persistent high levels of hCG, pelvic pain, or an enlarged uterus. In advanced cases, if the cancer spreads to organs like the lungs or brain, symptoms may include cough, breathlessness, headaches, or neurological changes.”

How to Diagnose Choriocarcinoma?

Choriocarcinoma is diagnosed using standard tests that check the body and hormone levels. Dr Kundur shares them for us:

• Doctors first do a blood test to measure high levels of hCG, which remains elevated even when not pregnant.
• An ultrasound scan of the uterus helps identify any abnormal growth.
• Imaging tests such as chest X-ray, CT scan, or Magnetic Resonance Imaging (MRI) are done to see if the cancer has spread to the lungs or the brain.
• A detailed medical history, especially recent pregnancy events, is important.
• Sometimes, doctors may also examine tissue samples to confirm the diagnosis.

“Diagnosis is usually based on persistently elevated or rising hCG levels after a pregnancy event, along with imaging studies such as ultrasound, CT scan, or MRI, to assess the extent of disease and detect spread,” adds Dr Raizada.

Risks and Complications of Choriocarcinoma

Dr Kundur shares that choriocarcinoma has risk factors such as: 

• A previous molar pregnancy.
• History of miscarriage or abortion.
• Women at a very young or older reproductive age.
• High levels of hCG and past trophoblastic disease also increase risk. 

Regarding its complications, the expert says, “If not treated early, it can lead to serious complications because it spreads quickly through the blood. Common complications include spread to the lungs, causing breathing problems, to the brain, causing seizures, and to the liver, causing pain or bleeding. Severe blood loss, anaemia, and organ damage can also occur if the disease advances.”

Adding to this, Dr Raizada says, “If left untreated, complications can be serious, including metastasis to lungs, liver, or brain, and life-threatening bleeding.”

A 2024 study, published in the ‘Paediatric Blood and Cancer’ journal, examined whether choriocarcinoma can affect infants. The findings noted that this is a rare scenario. They examined eight affected babies, all of whom had widespread tumours. The study, however, added on a positive note that severe cancer in infants can be cured with the right treatment and therapy. 

How Is Choriocarcinoma Treated?

Dr Raizada says that despite its aggressive nature, choriocarcinoma is highly treatable, especially when detected early. She adds, “Treatment primarily involves chemotherapy, which is very effective in most cases. In selected situations, surgery or radiation therapy may be required. Regular follow-up with hCG monitoring is essential to ensure complete remission and detect any recurrence early.”

Choriocarcinoma has different treatment options. Explaining them, Dr Kundur lists the following: 

• Choriocarcinoma is usually treated with strong medicines called chemotherapy, which is very effective in most cases.
• Doctors choose single or multiple drug treatment based on how advanced the disease is.
• Blood tests are done regularly to check the hCG levels and monitor the response.
• In some cases, surgery like the removal of the uterus may be needed, especially if bleeding is severe.
• Radiation therapy may be used if the cancer has spread to the brain. 

“With early diagnosis and proper treatment, most patients can recover well and have good long-term outcomes,” adds the expert.

A 2025 study, published in the ‘Case Reports in Women's Health’ journal, stated that choriocarcinoma spreads quickly through the bloodstream, but is the most curable form of solid tumour. The findings stated that it has a 90% survival rate with the right treatment at specialised centres. The study added that low-risk choriocarcinoma is treated with a single chemotherapy drug, while high-risk choriocarcinoma needs a more aggressive, multi-drug chemotherapy.

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Conclusion

Choriocarcinoma is a rare and aggressive form of cancer. It usually stems from the uterus or ovaries. Gestational choriocarcinoma is the most common type. It is diagnosed using standard tests that check the body and hormone levels. The majority of recovered patients have early diagnosis and the right treatment.