Choriocarcinoma : Prognosis
Prognosis: Choriocarcinoma (CC) is the most aggressive malignant germ cell tumor of the testis with a tendency to early metastases via hematogenous route. Patients usually present with advanced disease at the time of diagnosis. The most common metastatic sites are lung, liver, gastrointestinal tract, brain, spleen, and adrenals. Pure CC and predominant CC in a mixed germ cell tumor (where CC makes up >50% of tumor volume) have poor outcomes. Elevations of serum hCG beyond 50,000 mIU/L predict poor response to treatment and adverse prognosis (ref. range of hCG in adult male is 0-3 mIU/L). With combination chemotherapy, the 3-yr survival rate is about 20%. The image shows classic biphasic appearance in a choriocarcinoma consisting of mononucleated cytotrophoblastic cells with clear cytoplasm closely associated with and capped by multinucleated syncytiotrophoblasts with deeply eosinophilic cytoplasm.