{"entity":{"id":"testicular-choriocarcinoma","kind":"cancer","name":"Choriocarcinoma of the testis","aka":["Testicular choriocarcinoma","Choriocarcinoma (very high hCG, haemorrhagic metastases)","Pure choriocarcinoma of the testis","Choriocarcinoma-predominant germ cell tumour"],"tldr":"Choriocarcinoma is the rarest and most dangerous form of non-seminoma testicular cancer, made of placenta-like cells that pour out the pregnancy hormone hCG and spread early through the blood to the lungs, liver and brain, where they can bleed. Fewer than eight in ten men survive five years, against more than 95 for testicular cancer overall, so it is treated urgently with intensive chemotherapy.","summary":"Choriocarcinoma is a trophoblastic germ cell tumour of syncytiotrophoblasts and mononucleated trophoblasts, arising from germ cell neoplasia in situ and usually as a component of mixed tumours (Moch 2016). In the 1,010-orchidectomy series, pure and predominant choriocarcinoma together made up 1.5 percent; all patients had markedly raised serum beta-hCG (median 199,000 IU/L), tumours averaged 6.5 cm, and the histology showed expansile haemorrhagic nodules surrounded by trophoblastic cells with plexiform aggregates (Am J Surg Pathol 2014). Five-year survival is under 80 percent against over 95 percent for testicular germ cell tumours overall; the choriocarcinoma syndrome, bleeding from metastatic sites at presentation or on starting chemotherapy, is a medical emergency with high morbidity and mortality (Current Oncology Reports 2015).\n\nHow it differs from its parent: haematogenous rather than lymphatic spread, so lung, liver and brain metastases without bulky retroperitoneal nodes; beta-hCG in the tens or hundreds of thousands, which alone places a patient in the poor-risk group; and a tendency to bleed that shapes the first days of treatment.\n\nHow common: about 1.5 percent of orchidectomies for germ cell tumour when pure and predominant cases are combined (Am J Surg Pathol 2014).\n\nTreatment: as poor-risk non-seminoma with four cycles of BEP or VIP, sometimes with a reduced first cycle to limit bleeding, aiming at marker normalisation; refractory disease goes to high-dose chemotherapy and trials such as TIGER; brain metastases are treated with chemotherapy first and surgery or radiotherapy for residual disease (Current Oncology Reports 2015; the parent page).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Choriocarcinoma","links":[{"label":"NCI PDQ: testicular cancer treatment","url":"https://www.cancer.gov/types/testicular/treatment"},{"label":"Moch 2016, European Urology: the 2016 WHO classification of urinary and male genital tumours, part A","url":"https://doi.org/10.1016/j.eururo.2016.02.029"},{"label":"Am J Surg Pathol 2014: choriocarcinoma as a pure or predominant component of testicular germ cell tumour, 1,010 orchiectomies","url":"https://doi.org/10.1097/pas.0b013e3182a2926e"},{"label":"Current Oncology Reports 2015: testicular choriocarcinoma, a rare variant needing a unique treatment approach","url":"https://doi.org/10.1007/s11912-014-0430-0"}],"tags":["subtype-page","wave4","testicular","rare"],"related":["non-seminoma","testicular","embryonal-carcinoma-testis","yolk-sac-tumour-postpubertal","gestational-trophoblastic","mediastinal-germ-cell-tumour"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":["bleomycin","etoposide","cisplatin","ifosfamide","methotrexate"],"companies":[],"institutions":[],"pathways":[],"terms":["tumour-markers"],"trials":["tiger-trial"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"genitourinary","burden":"Rare: 6 pure (0.6 percent) and 9 choriocarcinoma-predominant (0.9 percent) tumours among 1,010 orchiectomies over 1999 to 2011 at one cancer centre; patients aged 20 to 39, median 29 (Am J Surg Pathol 2014).","subtypes":["Pure choriocarcinoma of the testis (0.6 percent of orchidectomies)","Choriocarcinoma-predominant mixed germ cell tumour","Choriocarcinoma syndrome (haemorrhage from metastases at presentation or on starting treatment)","Non-choriocarcinomatous trophoblastic tumours (placental site and cystic trophoblastic tumour; rare)"],"biomarkers":["Serum beta-hCG (very high; poor-risk marker level)","Beta-hCG and GATA3 on immunohistochemistry","Lung, liver and brain imaging at diagnosis","Haemoglobin and signs of bleeding during induction"],"standardOfCare":[{"setting":"All cases","approach":"Treated as poor-risk non-seminoma: four cycles of BEP or VIP with care for bleeding, resection of residual disease, high-dose chemotherapy or trials for refractory disease.","refs":["non-seminoma","testicular","bleomycin","etoposide","cisplatin","ifosfamide","tiger-trial"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"non-seminoma"},"route":"/cancers/testicular-choriocarcinoma/","neighbours":{"cancer":[{"id":"embryonal-carcinoma-testis","kind":"cancer","name":"Embryonal carcinoma of the testis","route":"/cancers/embryonal-carcinoma-testis/"},{"id":"gestational-trophoblastic","kind":"cancer","name":"Gestational trophoblastic neoplasia","route":"/cancers/gestational-trophoblastic/"},{"id":"mediastinal-germ-cell-tumour","kind":"cancer","name":"Mediastinal germ cell tumour","route":"/cancers/mediastinal-germ-cell-tumour/"},{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"},{"id":"testicular","kind":"cancer","name":"Testicular germ cell tumours","route":"/cancers/testicular/"},{"id":"yolk-sac-tumour-postpubertal","kind":"cancer","name":"Yolk sac tumour of the testis, postpubertal type","route":"/cancers/yolk-sac-tumour-postpubertal/"}],"drug":[{"id":"bleomycin","kind":"drug","name":"Bleomycin","route":"/drugs/bleomycin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"ifosfamide","kind":"drug","name":"Ifosfamide","route":"/drugs/ifosfamide/"},{"id":"methotrexate","kind":"drug","name":"Methotrexate","route":"/drugs/methotrexate/"}],"term":[{"id":"tumour-markers","kind":"term","name":"Tumour markers (CEA, LDH, chromogranin, thyroglobulin)","route":"/terms/tumour-markers/"}],"trial":[{"id":"tiger-trial","kind":"trial","name":"TIGER: standard-dose TIP versus high-dose TI-CE with stem cell transplant as first salvage for relapsed germ cell tumours","route":"/trials/tiger-trial/"}]}}