A 20-year-old woman with a rapidly enlarging pelvic mass has serum beta-hCG of 90,000 mIU/mL. Hysterectomy specimen shows a haemorrhagic ovarian tumour composed of cytotrophoblast and syncytiotrophoblast. Which feature on histology distinguishes this non-gestational tumour from gestational trophoblastic disease?

• A Presence of intermediate trophoblast
• B Absence of chorionic villi
• C Marked nuclear atypia of syncytiotrophoblast
• D Presence of other germ cell elements ✓

Explanation

Non-gestational ovarian choriocarcinoma arises from germ cells and often contains admixed other germ cell components such as dysgerminoma or yolk sac tumour, whereas gestational choriocarcinoma is purely trophoblastic. Both lack chorionic villi and both produce very high beta-hCG. Identification of additional germ cell elements confirms the non-gestational origin.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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