title: Primary choriocarcinoma of the renal pelvis presenting as intracerebral hemorrhage: a case report and review of the literature.
abstract: BACKGROUND
  A choriocarcinoma is a malignant neoplasm normally arising in the gestational trophoblast, gonads and, less frequently, the retroperitoneum, mediastinum and pineal gland. Primary choriocarcinomas of the renal pelvis are extremely rare.
  
  
  METHODS
  We report a case of primary choriocarcinoma of the renal pelvis in a 38-year-old Greek woman of reproductive age, presenting with a sudden development of intracerebral hemorrhage due to metastatic lesions. The diagnosis was established with a renal biopsy, along with an elevated serum level of beta-human chorionic gonadotropin. An extensive diagnostic work up confirmed the origin of the choriocarcinoma to be the renal pelvis.
  
  
  CONCLUSIONS
  Extragonadal choriocarcinomas are rare neoplasms that require extensive laboratory and imaging studies to exclude a gonadal origin. Moreover, this is the first case of severe intracerebral hemorrhage as the initial presentation of primary choriocarcinoma of the renal pelvis. Nonetheless, choriocarcinomas should be considered in the differential diagnosis of women of reproductive age.
authors.affiliation: 1st Critical Care Department and Pulmonary Services, Evangelismos General Hospital, University of Athens Medical School, Ipsilantou 45-47, 10676 Athens, Greece. fkiriakou@yahoo.com.
authors.forename: Fani
authors.initials: F
authors.lastname: Kyriakou
authors.forename: Michael M
authors.initials: MM
authors.lastname: Vaslamatzis
authors.forename: Styliani
authors.initials: S
authors.lastname: Bastani
authors.forename: Maria Alexandra
authors.initials: MA
authors.lastname: Lianou
authors.forename: Christina
authors.initials: C
authors.lastname: Vourlakou
authors.forename: Antonia
authors.initials: A
authors.lastname: Koutsoukou