Table 1. A summary of all cases of gestational choriocarcinoma, reported in literature with suspected or confirmed, vertical transmission.

Author and year of publication	Age/type of cancer/primary site	Mode of delivery/ GA at birth	Child’s Sex/age at diagnosis	Presenting features for the baby	Site of metastasis in the baby	Route of transmission	How was vertical transmission confirmed?	Placental histopathology, if available. (Villous invasion, if present)	Outcome in the baby	Outcome in the mother	Remarks
Mercer et al. (3)	NM/Choriocarcinoma/ Uterus (a blackish-red nodule 1.5 X 1.5 cm, located in the fundus)	VD/Full-term	NM/3 months	Small red nodule in the upper anterior alveolar ridge	Upper maxilla, nasal fossa and later head and neck	Transplacental ?	Not confirmed	Not done	Died  at 6 months of age d/t extensive invasion of the tumor about the head and face.	Death at 8 months pp due to widely metastatic disease.	Whether the tumor of the alveolar ridge of the infant represented a primary or a secondary metastasis is unknown.
Brooks and Nolting (4)	NM/Choriocarcinoma/Diagnosed with metastatic disease after child’s confirmation.	VD/35 weeks	Female/11 days	Right-sided facial mass, Recurrence of facial mass after resection	Lung	Transplacental ?	Not confirmed	Not done	Survived	Alive and Healthy	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Hanson et al. (5)	NM/Choriocarcinoma/ Diagnosed with metastatic disease after child’s confirmation.	NM	Male/6 weeks	Fever, pallor, and fatigue, Recurrent severe anaemia, hepatomegaly	Liver	Transplacental ?	Not confirmed	Not done	Survived	Survived	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Sashi et al. (6)	NM/Choriocarcinoma/ Diagnosed with metastatic disease after child’s confirmation.	NM/full term	Female/At birth	Anaemia, abdominal distension, Tachycardia, cyanosis, liver tumours	Liver, lung, brain	Transplacental ?	Not confirmed	Not done	Died at 38 days d/t metastatic disease.	Survived till 14 months from diagnosis and later	In this case there were two possible primary sites: the placenta of this pregnancy and the hydatidiform mole occurring 2 years before.
Andreitchouk et al. (7)	36/Choriocarcinoma WHO score 13/ Uterus with widespread metastasis diagnosed after confirmation in child	CS (CPD)/ full-term	Female/At birth	Severe anaemia Hepatomegaly	Liver, lung, brain.	Transplacental ?	Not confirmed	Placenta grossly normal. HPE not done	Died at 38 days of life d/t metastatic disease.	Remission	Origin could have been from hydatiform mole 2 years before this pregnancy. Feto-maternal haemorrhage was noted.
Avril et al. (8)	21/   choriocarcinoma/placenta with lung metastasis	VD/ full-term	Female/At birth	Cutaneous lesions Disseminated cutaneous tumours, hepatomegaly, lung rales	Skin, lung, bone, pelvis	Transplacental	Confirmed because placenta was involved pathologically	An abnormal 5 cm wide white growth on the uterine surface, pathologically confirmed as choriocarcinoma	Died at day 24 of life d/t lung haemorrhage	Alive at 14 monthsNo further details available	None
Bolze et al. (9)	35/    Choriocarcinoma FIGO Stage 4 Score 14/ Uterus	NM/NM	Male/ 5 month	Dyspnea and anaemia, Liver mass, mediastinallymphadenopathy.	Liver, lung, mediastinal lymph nodes	Transplacental confirmed	Genotyping	Placenta grossly normal. HPE not done	Died at 11 months of age	Normal at 3 years f/u.	None
Flam et al. (10)	30/choriocarcinoma/uterus	VD/ full-term	Female/ 24 hours of life	Anaemia Liver tumour	Liver	Transplacental?	Not confirmed	Placenta grossly normal. HPE not done	Died at 20 days of life (sudden death at home)	Alive at 7 years	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Rzanny-Owczarzak et al. (11)	NM/ choriocarcinoma/uterus	CS (NPOL)/ full-term	Male/ 1 month	Hematemesis Liver tumour	Lung, liver, intestine, lymph nodes	Transplacental?	Not confirmed	Not mentioned	Died at 1.5 months d/t MODS	Alive and pregnant at 1 year	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Liu and Guo (12)	35/ Choriocarcinoma stage IIIa (FIGO score 4) / Uterus, metastatic to lungs.	VD/ full-term	Male/ Day 13 of life	Unexplained melena, Jejunal mass	Lung, jejunum,	Transplacental?	Not confirmed	Not mentioned	Survived	Normal at 1 year f/u	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Tsukamoto et al. (13)	24/ choriocarcinoma/uterus	VD of dead baby/ full-term	Male/ Intrauterine fetal demise	Unexplained intrauterine fetal death Metastatic liver disease	Liver, lungs, hilar lymph nodes, diaphragm, and subcutaneous tissue of the head	Transplacental?	Not confirmed	Placenta was enlarged but grossly normal, sent for HPE but found normal	Intrauterine fetal death	Asymptomatic at 9 months f/u	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Buckell and Owen (14)	25/ choriocarcinoma/uterus	NM/ full-term	Male/ 7 weeks	Vomiting, abdominal distension, Anaemia, epigastric mass	Liver, ribs and nodes	Transplacental?	Not confirmed	Not mentioned	Died at 52 days of life	Alive at 13 months pp	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Kruseman et al. (15)	20/ choriocarcinoma/uterus and vagina	VD of dead baby/ full-term	Female/ Intrauterine fetal death	Still birth, polyhydramnios, Tumour in left kidney 1.2x1.8 cm	Kidney	Transplacental ?	Both tumours were similar on Immuno-histochemistry.	Not mentioned	Intrauterine fetal death	Alive at 6 months	Massive Feto-maternal haemorrhage. Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Mosayebi et al. (16)	22/ choriocarcinoma	CS (morbid maternal condition)/ 31 weeks	Female/ 6 weeks	Recurrent vomiting and poor feeding, Sick child, decreased neonatal reflexes, systolic murmur, bilateral megalo-cornea and leukocoria	Brain, lung, liver and eye	Transplacental?	Not confirmed	Not done	Died	Died at 30 days pp	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Mcnally et al (17); Heath and Tiedemann (18)	35/ choriocarcinoma/ Uterus and placenta	VD/ full term	Male/ 3 months	Solitary liver nodule	Liver	Transplacental	Confirmed by HPE of placenta	Placenta involved grossly and microscopically (Villous invasion present)	Alive and Healthy at 3 years	Alive and healthy at 36 months, following multiple courses of chemotherapy and related complications	h/o hydatiform mole, before this pregnancy, which went on to develop CC
Aozasa et al. (19)	NM/ choriocarcinoma not confirmed on HPE/ Uterus	VD/ full-term	Female/ 2 months	Weakness of feeding and oedema in the right inguinal and labial region, Hepatomegaly, abdominal distension, thrombocytopenia,	Liver, lung	Transplacental?	Not confirmed	No comment on placental examination	Died	Died at 5 months pp	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Getrajdman et al. (20)	33/ choriocarcinoma	VD/ 37 weeks	Male/At birth	Pallor Hepatomegaly and anaemia	Liver, lung, eyes	Transplacental?	Not confirmed.	No comment on placental examination	Survived and disease free at 2 years	Alive and Healthy at 2 years	Not clear whether the infant’s tumor was primary, or secondary to maternal CC
Kishkurno et al. (21)	36/ choriocarcinoma	CS (CPD)/ full-term	Female	Anaemia, hepatomegaly	Liver, brain, lungs	Transplacental?	Not confirmed	Placenta grossly normal. HPE not done	Died at 38 days of life d/t widespread metastasis	Alive and healthy	Origin could have been from hydatiform mole 2 years before this pregnancy. Feto-maternal haemorrhage was noted
Picton et al. (22)	24/choriocarcinoma high risk with prognostic score 17/ Diagnosed with metastatic disease after child’s confirmation	CS  (fetal distress)/40 weeks	Male/Day 22 of life	Feeding difficulty, poor weight gain, anaemia, vomiting Failure to thrive, hepatosplenomegaly	Brain, liver, lung	Transplacental??	Not confirmed.	On gross examination, membranes appeared ragged, but HPE not done.	Died at 1 month d/t widespread metastasis.	Alive and healthy at 11 months	Feto-maternal haemorrhage was noted
Monclair et al. (23)	32/PSTT high risk WHO prognostic score 9	NM/ 37 weeks	Male/4 months	General malaise, common cold Hepatomegaly, dyspnoea, tachycardia, pneumothorax	Liver, lung, mesentery	Transplacental??	Not confirmed. Both tumours were similar on Histology and Immunohistochemistry	Placenta was grossly normal, but histopathology was not done	Died at 5 months d/t MODS	Alive and Healthy at 26 months	Not clear whether the infant’s tumor was primary, or secondary to maternal PSTT

CC: Choriocarcinoma, CPD: Cephalo-pelvic disproportion, CS: Caesarean section, CT: Computer tomography, d/t: Due to, f/b: Followed by, f/u: Follow-up, HPE: Histopathological examination, IUFD: Intra-uterine fetal death, LSCS: Lower segment caesarean section, NAD: No abnormality detected, NM: Not mentioned, NPOL: Non-progress of labour, MODS: Multi-organ dysfunction syndrome, pp: Post-partum, PSTT: Placental site trophoblastic tumor, VD: Vaginal delivery, WHO: World Health Organization