Gestational choriocarcinoma in Denmark 1940-1969. A reappraisal based on modern histologic criteria.

Abstract

In Denmark, 94 cases of trophoblastic disease were classified as choriocarcinoma (CHC) or “probably CHC” during the period 1940–1969. All these cases were subjected to a reappraisal in the study presented here. Based on the criteria laid down by the Armed Forces Institute of Pathology, 50 of the cases were classified as CHC, 18 as invasive moles (IM), and 26 as other trophoblastic proliferations (OTP).Among the CHC patients, 30 died of generalized disease and one from postoperative complications. Eighteen patients (36%)—10 of them with metastases—recovered. Four of these patients have been observed for 2–5 years and 14 for more than 5 years. Finally, one patient has still active disease.Forty‐four patients suffering from IM (18) or OTP (26) were cured of their disease, including 5 with metastases. Determination of chorionic gonadotrophs was performed in 88 of the 94 patients at the time of the original diagnosis. Based on the findings at the re‐evaluation, the frequencies of IM and CHC were one case per 126 000 and 49 000 births, respectively. The ratio of IM to CHC was 1 to 2.6. As compared with Norway and Sweden, Denmark seems to have the lowest incidence of these diseases. During the years 1943–1963, CHC accounted for approx. 0.03% of all malignant neoplasms in Danish females.The study reported here forms the basis of subsequent immunologic investigations into the transplantation aspects of CHC and IM.