title: Metastatic cerebral choriocarcinoma coexistent with a viable pregnancy.
abstract: Gestational choriocarcinoma associated with a viable pregnancy is extremely rare, and such choriocarcinoma with metastases presenting during the pregnancy is even more exceptional. Metastases from this tumor may present in a variety of ways depending on the site of the metastatic lesion, and can be fatal before choriocarcinoma is even suspected. We describe a 32-year-old primigravida presenting at 31 weeks gestation with a grand mal seizure due to cerebral metastases secondary to gestational choriocarcinoma who was subsequently successfully treated with chemotherapy. To our knowledge this is the first reported case of choriocarcinoma presenting with signs due to cerebral metastases during pregnancy where both the mother and child survived. This paper emphasizes the need to consider metastatic choriocarcinoma in any gravid female who presents with unusual neurological signs because of the life-threatening nature of this potentially curable disease.
authors.affiliation: Department of Medical Oncology, Charing Cross Hospital, London, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Dana
authors.forename: G J
authors.initials: GJ
authors.lastname: Saldanha
authors.forename: R
authors.initials: R
authors.lastname: Doshi
authors.forename: G J
authors.initials: GJ
authors.lastname: Rustin
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D002822:Choriocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate