INFANTILE CHORIOCARCINOMA - REEXAMINATION OF A POTENTIALLY CURABLE ENTITY

Choriocarcinoma presenting in an infant or neonate is a rare entity th at in the past has been uniformly fatal. The authors present the first reported case of choriocarcinoma successfully treated in a 3-week-old infant. Choriocarcinoma was not suspected in this case until patholog ic examination revealed the diagnosis. In retrospect, however, the cas e fits well into the classic ''infantile choriocarcinoma syndrome'' in itially described by Witzleben in 1968. Review of additional cases rep orted since the initial description validates Witzleben's initial obse rvations and also indicates that the original definition should be bro adened to include other significant presentations of the disease not i nitially appreciated, specifically anemic infants with central nervous system symptoms as well as newborns and older children. The importanc e of making a correct and rapid diagnosis is emphasized by the success ful outcome in this case where aggressive surgery and subsequent chemo therapy have been curative. Serum beta-human chorionic gonadotropin (b eta-HCG) levels have been uniformly positive, providing easy confirmat ion of the diagnosis. Because the mother can also be affected, an appr opriate diagnosis of the infant may also lead to more rapid diagnosis and treatment of the mother.