Gestational Trophoblastic Disease

Question No. 3. The Answer is: (E) TAH/BSO is the standard treatment of choice.

Discussion: This is a choriocarcinoma. Chemotherapy is extremely effective for choriocarcinoma which makes it the first line of treatment. Choriocarcinoma has extremely high metastatic rate and tends to have distant metastasis at the time of presentation. Local resection (TAH/BSO) would not provide effective treatment. Choriocarcinomas are almost always associated with a very high level of  serum beta-hCG, due to the syncytiotrophoblastic component of the biphasic lesion. Choriocarcinomas are associated with complete moles. These lesions metastasize hematogenously, with the lungs being the most frequent site.

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