Can metastatic choriocarcinoma occur without a primary growth in the uterus?

ABSTRACT

Six cases of metastatic choriocarcinoma without a primary growth in the uterus are presented. Three cases followed early abortion, two cases after term pregnancy, and one case after hydatidiform moleTheories as to the occurrence of metastatic choriocarcinoma without primary lesion in the uterus are presentedThe normal chorionic cell has no inherent property of malignancy. It has an invasive property, it is true, but only to a limited extent for the implantation and nourishment of the fertilized ovum. When detached from the ovum and carried away by the circulation, the normal chorionic cell in time disintegrates and is eventually absorbed. When the fetus dies or is expelled, the normal chorionic cell degenerates and is eventually absorbed or discharged from the uterine cavityChorionic malignancy results from the abnormal chorionic cell produced by a defective gene. It has an inherent property of malignancy which may be potential (where malignancy is manifested after some time) or actual. The abnormal chorionic cell occurs only in certain specific cells among myriads of normal chorionic cells of a given pregnancy. The presence of the actually malignant cell in a given pregnancy explains the co-existence of choriocarcinoma and normal pregnancy with a living fetus and normal placentaThere are different degrees of malignancy. The highly malignant type manifest itself earlier than that of lesser malignancy, and it is most resistant to any form of treatment.(summary)