Histopathological examination of a uterine curetting from a woman who had a term delivery 9 months ago shows sheets of atypical cytotrophoblast and syncytiotrophoblast with extensive haemorrhage and necrosis, numerous mitoses, and NO chorionic villi. The most likely diagnosis is:
- A Invasive hydatidiform mole
- B Placental site trophoblastic tumour
- C Gestational choriocarcinoma ✓
- D Exaggerated placental site reaction
Correct answer: C. Gestational choriocarcinoma
Explanation
The hallmark of gestational choriocarcinoma is biphasic proliferation of malignant cytotrophoblast and syncytiotrophoblast with haemorrhage and necrosis and an absolute absence of chorionic villi. Invasive mole retains identifiable chorionic villi invading myometrium. Placental site trophoblastic tumour consists predominantly of intermediate trophoblast secreting human placental lactogen, not the cyto-syncytial pattern seen here. Exaggerated placental site is a benign reactive process without atypia, mitotic activity, or necrosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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