Choriocarcinoma presenting with cerebral metastases after full-term pregnancy

Acta Obstet Gynecol Scand. 1990;69(5):433-5. doi: 10.3109/00016349009013308.

Abstract

Choriocarcinoma is a rare malignancy in Scandinavia. We present a case of a young primigravida who experienced an uneventful pregnancy and gave birth to a healthy baby. Six days after delivery she underwent neurosurgery for intracranial hemorrhage. Pathological examination of the evacuated hematoma revealed metastatic choriocarcinoma. Further work-up exposed additional metastases in the lungs and liver. The initial serum level of human chorionic gonadotropin (beta-HCG) was 350,000 IU/I. Chemotherapy was given both intravenously and intrathecally. At 10 weeks, beta-HCG had returned to normal. Treatment was continued for another 10 weeks. Two years after cessation of therapy the patient is still in complete remission. In the discussion we review a scoring system to be used in selecting the mode of treatment, and briefly mention diagnosis and prognosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols*
  • Brain Neoplasms / secondary*
  • Choriocarcinoma / drug therapy
  • Choriocarcinoma / epidemiology
  • Choriocarcinoma / secondary*
  • Chorionic Gonadotropin / blood
  • Chorionic Gonadotropin, beta Subunit, Human
  • Cyclophosphamide / administration & dosage
  • Dactinomycin / administration & dosage
  • Female
  • Humans
  • Leucovorin / administration & dosage
  • Methotrexate / administration & dosage
  • Peptide Fragments / blood
  • Pregnancy
  • Sweden / epidemiology
  • Uterine Neoplasms / drug therapy
  • Uterine Neoplasms / epidemiology*
  • Uterine Neoplasms / pathology

Substances

  • Chorionic Gonadotropin
  • Chorionic Gonadotropin, beta Subunit, Human
  • Peptide Fragments
  • Dactinomycin
  • Cyclophosphamide
  • Leucovorin
  • Methotrexate

Supplementary concepts

  • MAC III protocol