Choriocarcinoma with brain, lung and vaginal metastases successfully treated without brain radiation or intrathecal chemotherapy: A case report

Frost, Anja; Sherman, Jonathan H.; Rezaei, Katayoon; Aron, Alivia; Lopez-Acevedo, Micael

doi:10.1016/j.gore.2017.03.014

Cited by 12 publications

(12 citation statements)

References 14 publications

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“…For patients with choriocarcinoma and solitary brain metastasis, craniotomy can be considered, followed by EMA-CO and high-dose intravenous methotrexate treatment. 18 Some studies suggest that craniotomy or stereotactic radiosurgery combined with etoposide, cisplatin and medium/high-dose methotrexate combined with chemotherapy can stabilize patients in the early stage of treatment and avoid whole brain radiotherapy or intrathecal chemotherapy. 19,20 A previous study reported that among 140 newly admitted high-risk patients with GTN admitted to the Charing Cross Centre, UK from 1995 to 2010, 33 of the very high-risk patients with a high tumour burden were given a low-dose EP transition before starting EMA-CO chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report

Zhang

Shen

et al. 2021

J Int Med Res

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Choriocarcinoma is a highly malignant gynaecological tumour. This disease becomes life-threatening once brain haemorrhage or brain herniation occurs. Timely and accurate brain surgery can gain treatment time for patients that have a large number of cerebral haemorrhages and/or brain herniation. This current report describes a case of choriocarcinoma secondary to a hydatidiform mole in a 55-year-old woman that presented with neurological symptoms. Following admission to hospital, computed tomography examination found that lung and brain metastases were accompanied by cerebral haemorrhage. Cerebral hernia occurred during induction chemotherapy treatment and emergency surgery was performed. The patient recovered after individual chemotherapy and rehabilitation treatment. Patients with a very high risk of choriocarcinoma with brain metastasis should be referred to a comprehensive medical centre. Necessary surgical treatment and individualized chemotherapy can reduce the mortality of patients with choriocarcinoma brain metastasis.

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Section: Discussionmentioning

confidence: 99%

Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report

Zhang

Shen

et al. 2021

J Int Med Res

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“…Cerebral metastasis is considered a poor prognostic factor and combination chemotherapy is advocated. [5] In a study, Xiao et al . presented a single-institute experience in the management of patients with brain metastasis from gestational trophoblastic neoplasia.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Hemorrhage in a Young Woman: An Unusual Initial Presentation of Undiagnosed Choriocarcinoma

Agarwal

Jain

Sharma

et al. 2019

Journal of Neurosciences in Rural Practice

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Choriocarcinoma is an uncommon tumor. Undiagnosed choriocarcinoma initially presenting with intracranial hemorrhage in an apparently healthy female is rare and presents a diagnostic difficulty. The authors report a case presenting as intracranial hemorrhage of unsuspected choriocarcinoma. As the measurement of beta-human chorionic gonadotropin (β-hCG) would have helped in the preoperative diagnosis, estimation of serum β-hCG levels is suggested in the diagnostic workup of a female of reproductive age group when radiological investigations are inconclusive. Craniotomy and excision of tumor followed by chemotherapy and radiotherapy may improve the outcome.

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“…Treatment choice is determined by size of tumor, number of metastases, and clinical urgency of treatment (Frost et al, 2017). There are cases that have required whole brain radiation, stereotactic radiation and intrathecal chemotherapy in addition to excisional surgery (Leslie et al, 1996; Newlands et al, 2002; Soper et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman

Gwacham

Brunt

Ernst

et al. 2019

Gynecologic Oncology Reports

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Gestational trophoblastic neoplasia (GTN) with brain metastasis is usually seen in patients with advanced disease. Ten percent of metastatic gestational trophoblastic disease involves the brain and spinal cord, most often manifesting as an intracerebral mass or subdural hematoma, and are generally known to be a poor prognostic factor ( Dadlani et al., 2010 ). Leptomeningeal metastases are tremendously rare and not well documented in the literature. A standardized treatment regimen for patients with brain metastases has not been established and is controversial due to a number of multimodal treatments that have been published in the literature without a prospective trial having been completed. We report a case of a patient with gestational trophoblastic disease that metastasized to the lung and leptomeninges, who after treatment with induction chemotherapy using etoposide (E) and cisplatin (P) followed by etoposide, methotrexate and dactinomycin (EMA) chemotherapy achieved a complete response without brain radiation ( Han et al., 2012 ).

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Choriocarcinoma with brain, lung and vaginal metastases successfully treated without brain radiation or intrathecal chemotherapy: A case report

Abstract: HighlightsThere is no consensus on optimal treatment for GTN and brain metastases.Brain metastasis treated with craniotomy and intravenous, EMA-CO chemotherapyIntravenous high-dose methotrexate may be adequate to treat brain metastases.

Cited by 12 publications

References 14 publications

Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report

Emergency craniotomy in patient with intracranial metastatic choriocarcinoma: a case report

Intracranial Hemorrhage in a Young Woman: An Unusual Initial Presentation of Undiagnosed Choriocarcinoma

Leptomeningeal spread of gestational trophoblastic neoplasia in a 19-year old woman

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