How is morphology of gestational choriocarcinoma?

➢ Choriocarcinomas usually appear as hemorrhagic, necrotic uterine masses. ➢ Sometimes the necrosis is so extensive that little viable tumor remains. ➢ The primary lesion may “selfdestruct,” and only the metastases tell the story. ➢ Very early, the tumor insinuates itself into the myometrium and into vessels. ➢ In contrast with hydatidiform moles and invasive moles, chorionic villi are not formed; instead, the tumor is composed of anaplastic cuboidal cytotrophoblasts and syncytiotrophoblasts. ➢ By the time a choriocarcinoma is discovered, widespread vascular spread usually has occurred to the lungs (50%), vagina (30%–40%), brain, liver, or kidneys. ➢ Lymphatic invasion is uncommon.