A 21-year-old nulliparous woman with a 5 cm right ovarian mass has serum beta-hCG of 110,000 mIU/mL with a negative urine pregnancy test. Histology shows sheets of cytotrophoblast and multinucleated syncytiotrophoblast with haemorrhage, and no chorionic villi. Other germ cell elements are absent. Which statement about this tumour is CORRECT?
- A It carries a better prognosis than gestational choriocarcinoma and responds to single-agent methotrexate
- B It is benign and managed by simple oophorectomy alone
- C It is less sensitive to chemotherapy than gestational choriocarcinoma and requires intensive multiagent platinum-based therapy ✓
- D It primarily secretes human placental lactogen rather than hCG
Correct answer: C. It is less sensitive to chemotherapy than gestational choriocarcinoma and requires intensive multiagent platinum-based therapy
Explanation
Non-gestational (ovarian) choriocarcinoma is a malignant germ cell tumour with cytotrophoblast and syncytiotrophoblast lacking villi, secreting very high hCG. Unlike gestational choriocarcinoma, which is highly chemosensitive because it is essentially an allograft, the nongestational form behaves more aggressively and needs multiagent platinum regimens such as BEP plus hysterectomy in selected cases. It secretes hCG, not hPL, and is never managed by observation or single-agent therapy.
Reference: Williams Gynecology, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.