Choriocarcinoma presenting with cerebral metastases after full-term pregnancy.
Choriocarcinoma is a rare malignancy in Scandinavia. We present a case of a young primigravida who experienced an uneventful pregnancy and gave birth to a healthy baby. Six days after delivery she underwent neurosurgery for intracranial hemorrhage. Pathological examination of the evacuated hematoma revealed metastatic choriocarcinoma. Further work-up exposed additional metastases in the lungs and liver. The initial serum level of human chorionic gonadotropin (beta-HCG) was 350,000 IU/I. Chemotherapy was given both intravenously and intrathecally. At 10 weeks, beta-HCG had returned to normal. Treatment was continued for another 10 weeks. Two years after cessation of therapy the patient is still in complete remission. In the discussion we review a scoring system to be used in selecting the mode of treatment, and briefly mention diagnosis and prognosis.
Department of Gynecologic Oncology, University Hospital, Linköping, Sweden.
K
K
Pihl
H
H
Malmström
E
E
Simonsen
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001932:Brain Neoplasms / Q000556:secondary*; D002822:Choriocarcinoma / Q000188:drug therapy / Q000453:epidemiology / Q000556:secondary*; D006063:Chorionic Gonadotropin / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D013548:Sweden / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology
D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D003609:Dactinomycin; D003520:Cyclophosphamide; D002955:Leucovorin; D008727:Methotrexate