A 24-year-old nulligravid woman presents with a rapidly enlarging pelvic mass and vaginal bleeding. Serum beta-hCG is 45,000 mIU/mL. Hysterectomy specimen shows a haemorrhagic ovarian tumour with cytotrophoblasts and syncytiotrophoblasts but no chorionic villi. There is no history of preceding pregnancy or molar gestation. Which feature distinguishes this tumour from gestational trophoblastic choriocarcinoma?
- A It is more chemosensitive than gestational choriocarcinoma
- B It arises from parthenogenetically activated maternal germ cells and carries a significantly worse prognosis ✓
- C It always coexists with a mature cystic teratoma
- D It produces AFP in addition to beta-hCG
Correct answer: B. It arises from parthenogenetically activated maternal germ cells and carries a significantly worse prognosis
Explanation
Non-gestational ovarian choriocarcinoma is a malignant germ cell tumour arising de novo from an oocyte, with purely maternal genetic material, unlike gestational choriocarcinoma which contains paternal genes and follows pregnancy or mole. It is far less chemosensitive, so prognosis is substantially worse despite identical histology of cytotrophoblast and syncytiotrophoblast without villi. Coexistence with teratoma is possible but not obligatory, and AFP production belongs to yolk sac tumour, not choriocarcinoma.
Reference: Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.