Trophoblastic neoplasm

Choriocarcinoma (trophoblastic neoplasms) Methotrexate alone or etoposide and cisplatin Vinblastine, mercaptopurine, chlorambucil, doxorubicin... 

Methotrexate is a folic acid antagonist that inhibits the enzyme dihydrofolate reductase. This agent is mainly used in the treatment of both cancer [trophoblastic neoplasms, leukemias, breast carcinoma, carcinoma of gastric, esophagus, testes, lymphomas] and non-cancer diseases [psoriasis rheumatoid arthritis]. Recent successful results using high-dose [>lg/ m ] methotrexate followed by leucoverin in the treatment of head and neck carcinomas and osteosarcoma has led to a more widespread use of this therapy in patients with these and other tumors. 

Acute lymphocytic leukemia Burkitt s lymphoma Hodgkin s lymphoma Choriocarcinoma (gestational trophoblastic neoplasm)... 

Niehans GA, Manivel JC, Copland GT, et al. Immunohistochemistry of germ cell and trophoblastic neoplasms. Cancer. 1988 62 1113-1123. 

Trophoblastic expression was evaluated for hCG and its derivatives, leutenizing hormone (EH, LH 3), follicle stimulating hormone (FSH, FSH 3), placental lactogen (PL), and growth hormone (GH-227) in 40 neuroendocrine lung neoplasms, 29 primary pulmonary adenocarcinomas, 20 squamous cell carcinomas, and 1 adenosquamous carcinoma.Trophoblastic hormone immunoreactivity was found in 28 of 90 (31%) of all lung carcinomas but primarily in typical carcinoids. 

This tumor is composed of chorionic site intermediate trophoblasts that tend to arise in the cervix where they have a rounded contour and a pushing pattern of stromal of stromal infiltration. FLAP and p63 are expressed, but hPL and HLA-G are not. 749 Owing to its frequently cervical location and its epithelioid, eosinophilic appearance, this tumor can be confused with squamous carcinoma. ETT shares expression of p63 with squamous cell carcinoma, but ETT expresses the trophoblast-associated markers inhibin, CD10, T267 CKIS, and HSD3B1. ETTs lack the pl6 expression that is typical of HPV-associated squamous neoplasms. ... 

It was previously thought that choriocarcinomas were biphasic neoplasms composed of mononuclear cyto-trophoblasts and multinucleate syncytiotrophoblasts. 

Shih IM, Kurman RJ. Epithelioid trophoblastic tumor—A neoplasm distinct from choriocarcinoma and placental site trophoblastic tumor simulating carcinoma. Am J Surg Pathol. 1998 22 1393-1403. 

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