title: Primary mediastinal choriocarcinoma with brain metastasis in a female patient.
abstract: Nongestational choriocarcinoma is very rare and carries a poor prognosis in female patients. In this report, the authors present a case of nongestational choriocarcinoma with brain metastasis in a female. A 58-year-old female with intermittent back pain was referred to a private hospital. On examination, a mediastinal tumor and a pancreatic tumor were detected. Endoscopic ultrasound-guided fine needle aspiration biopsy of the tumor was performed for histological evaluation. Pathological diagnosis was difficult because only a small amount of tissue was collected. Head MRI showed multiple metastatic tumors in the brain. The patient was diagnosed with primary mediastinal choriocarcinoma with brain metastasis. She was treated with one course of an etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine regimen, but her general condition gradually deteriorated, and she died on day 41. Nongestational choriocarcinoma is drug resistant, whereas gestational choriocarcinoma has better chemotherapeutic sensitivity.
authors.forename: I
authors.initials: I
authors.lastname: Kuno
authors.forename: Y
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: M
authors.initials: M
authors.lastname: Kasai
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: Y
authors.initials: Y
authors.lastname: Hashiguchi
authors.forename: T
authors.initials: T
authors.lastname: Ichimura
authors.forename: T
authors.initials: T
authors.lastname: Yasui
authors.forename: T
authors.initials: T
authors.lastname: Sumi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D031954:Choriocarcinoma, Non-gestational / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008727:Methotrexate