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Observations on Choriocarcinoma in Singapore

From the University Department of Obstetrics and Gynaecology, Kandang Kerbau Hosiptal, Singapore.

Abstract

The incidence of choriocarcinoma in Singapore is 1 in 4298 deliveries. The incidence increased in patients over 40 years of age, in grand multiparas, in Malays and after hydatidiform mole. There were 34 nonmetastatic (uterine) chorio-carcinomas. Of 88 metastatic choriocarcinomas, there were 76 with pulmonary, 16 with brain and 12 with vaginal metastases. Uterine lesions presented with irregular bleeding, subinvolution, abdominal pain and occasionally an acute abdomen. Pulmonary lesions were usually silent but some presented with hemoptysis, cough, dyspnea and chest pain. Cerebral lesions produced headache, giddiness, machine-like noises in the head, blurred vision and convulsions. Patterns of human chorionic gonadotrophin were usually typical. Overall mortality rate was 29.5%, but was higher in the older age group, in those with a prolonged pregnancy-malignancy interval and in metastatic disease.