[Metastatic and hemorrhagic brain arteriovenous fistulae due to a choriocarcinoma. Case report].
Brain metastasis of choriocarinoma is uncommon. These tumors develop in women of childbearing age and commonly produce signs and symptoms of subarachnoid hemorrhage, intracerebral hemorrhage, or brain tumor. Diagnosis can be established by histologic study of operative swabs and bioassay of the patient's blood, urine and cerebrospinal fluid for chorionic gonadotropin. This condition is highly chemo- and radiosensitive. We report the case of a 36-year-old woman with intracranial neoplastic fistulae. Rupture occurred 3 days after spontaneous abortion at 3 months of pregnancy. The patient presented with hemiplegia, aphasia and unclear consciousness. Left fronto-parietal hematoma was diagnosed on the CT scan, and cerebral angiography showed an arteriovenous intracranial fistulae. The hematoma and angioma were surgically removed successfully. The histological examination showed a metastatic choriocarcinoma. Surgery was followed by chemotherapy and radiotherapy. After 6 years of follow-up, complete remission has been obtained.
Fadli
M
M
Service de Neurochirurgie (Pr Bellakhdar), CHU Ibn Sina, BP 8056 Rabat-Nations Unies, Rabat, Maroc, Spain.
Lmejjati
M
M
Amarti
A
A
El Hassani
M R
MR
El Abbadi
N
N
Bellakhdar
F
F
D000022:Abortion, Spontaneous; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D001037:Aphasia / Q000209:etiology; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000601:surgery; D001925:Brain Damage, Chronic / Q000209:etiology; D002536:Cerebral Arteries / Q000473:pathology* / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002550:Cerebral Veins / Q000473:pathology* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002822:Choriocarcinoma / Q000150:complications / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D003244:Consciousness Disorders / Q000209:etiology; D016371:Cranial Irradiation; D003399:Craniotomy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005625:Frontal Lobe / Q000601:surgery; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D010296:Parietal Lobe / Q000601:surgery; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery; D011644:Puerperal Disorders / Q000209:etiology*; D018714:Radiotherapy, Adjuvant; D012422:Rupture, Spontaneous; D015173:Supratentorial Neoplasms / Q000150:complications / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D014594:Uterine Neoplasms / Q000473:pathology*
D003520:Cyclophosphamide; D008727:Methotrexate