RELATION OF VESICULAR MOLE TO CHORION CARCINOMA 151 
PART III. CHORION CARCINOMA 
This condition, under the name of ' Sarcoma Deciduo Cellulare,' was first 
described by Sanger, in 1888, as a ' malignant deciduoma-forming metastasis.' 
In 1890, Pfeiffer independently published notes of a similar case, and 
proposed for it the name of ' Deciduoma Malignum.' Since that time considerable 
attention has been paid to the subject, especially by continental observers, and the 
literature is already somewhat extensive. 
It seems doubtful, however, if all the cases published under this heading have 
been genuine cases of what is understood by the term ' Chorion Carcinoma ; ' and 
since there has been so much difference of opinion expressed as to its pathology, even 
by eminent workers, we are inclined to believe that three classes of cases have been 
described. 
1. A true carcinoma developing from remains of a vesicular mole or retained 
chorionic elements. 
1. A sarcoma of the uterus developed during and influenced by pregnancy, 
and 
3. Ordinary forms of uterine carcinoma (Eden). 
As will be seen later, in studying the pathology of this disease, we regard the 
name ' Deciduoma Malignum ' as misleading and incorrect, there being no evidence 
that decidual cells ever take on a malignant growth, and from what has already been 
seen, it is obvious that the syncytial cells for which they have been mistaken, bear 
only a very superficial resemblance to those found in the decidua. 
The disease is a fatal one, death occurring in some cases as early as one month 
after the termination of the pregnancy. It is characterized by the presence of a uterine 
tumour, which grows with great rapidity, and is almost invariably accompanied by 
haemorrhages and an offensive discharge. It tends to infiltrate the wall of the uterus, 
even to perforation, and spreads locally by means of metastasis, which occur along the 
venous channels. 
Etiology of the Disease 
Age. Chorion Carcinoma may occur at any age during the child-bearing 
period, but is strictly limited to that period. Cases have been recorded as early as 
15 and as late as 53, but the largest number seem to have occurred at that period 
when the maternal functions are in the greatest state of activity, i.e., between 20 and 
35- 
But more important than the age factor is the nature of the pregnancy imme- 
diately preceding the development of the disease. 
