Emergency craniotomy in patients with intracranial metastatic gestational trophoblastic tumor.
OBJECTIVE
To study the diagnosis, management and prognosis of intracranial metastases of gestational trophoblastic tumor (GTT) patients who had emergency craniotomy.


METHODS
Sixty three intracranial metastases of GTT patients were hospitalized in Peking Union Medical College Hospital from 1985 to 2004. Thirteen of them had craniotomy that were retrospectively analyzed and all of them had a feature of raised intracranial pressure followed by intracranial hemorrhagic mass.


RESULTS
Of the thirteen patients who had undergone surgery combined with multiagent chemotherapy, seven got complete remission (CR), five got partial remission (PR), and one died of progress of the disease (PD). There were three patients who died (23.1%) during or after therapy.


CONCLUSIONS
Emergency craniotomy has a small but important role to play in selected patients with brain metastases who display rapidly deteriorating signs. An undetermined intracranial hemorrhage in young female patients of a reproductive age group should raise the suspicion of cerebral metastatic GTT.
Yang
J J
JJ
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Xiang
Y
Y
Yang
X Y
XY
Wan
X R
XR
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D003399:Craniotomy; D004630:Emergencies; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000150:complications / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000601:surgery; D019586:Intracranial Hypertension / Q000209:etiology / Q000601:surgery; D011247:Pregnancy; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies