Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report.
The authors report the case of a woman who presented during her 30th week of pregnancy with a large brain metastasis from a previously undetected metastatic choriocarcinoma. The metastasis caused significant neurological deficit due to mass effect, necessitating rapid intervention. Medical management included a regimen of high-dose corticosteroid medications for 36 hours, followed by cesarean delivery of the fetus and craniotomy to remove the metastatic tumor, chemotherapy and radiation therapy were begun within 1 week postsurgery. Both the baby and mother survived, and as of the 1-year follow-up examination, there was no evidence of disease in the mother. This is only the second report of a metastatic choriocarcinoma associated with a simultaneous viable intrauterine pregnancy, and the only case in which surgical removal of a brain metastasis was required. Coordinated multidisciplinary treatment of mother and fetus by members of the neurosurgery, medical oncology, neonatology, and obstetrics services facilitated a good outcome in this case.
Department of Neurosurgery, Huntington Memorial Hospital, Pasadena, California, USA. amamelak@coh.org
Adam N
AN
Mamelak
Gregory J
GJ
Withers
Xuedong
X
Wang
D000328:Adult; D001932:Brain Neoplasms / Q000556:secondary* / Q000601:surgery*; D002585:Cesarean Section; D002822:Choriocarcinoma / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery*; D011256:Pregnancy Outcome; D014594:Uterine Neoplasms / Q000473:pathology*