Intracranial hemorrhage due to metastatic chorionepithelioma

Vaughan, Herbert G.; Howard, Rudolph G.

doi:10.1212/wnl.12.11.771

Cited by 46 publications

(8 citation statements)

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“…Discrete organs involved in 512 cases of choriocarcinoma reviewed by Park & Lee (3) were as follows: lung, 94 per cent; vagina, 44 per cent: brain, 28 per cent; liver, 28 per cent; kidney, 25 per cent; and ovary, 22 per cent. Vaughan & Howard (8) reported that 20 per cent of their chorioepithelioma cases had brain metastases. Of 92 trophoblastic tumor cases from the Department of Obstetrics and Gynecology, Tokyo Medical College, pulmonary metastases were found in 55.4 per cent and brain metastases in 13 per cent (5).…”

Section: Discussionmentioning

confidence: 99%

Radioimmunoassay of hCG as an Early Diagnosis of Cerebral Metastases in Choriocarcinoma Patients

Soma

Takayama

Tokoro

et al. 1980

Acta Obstet Gynecol Scand

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To determine the early cerebral involvement of choriocarcinoma, the following studies were employed. By comparing hCG titers in measurements of serum and cerebrospinal fluid (CSF) hCG-beta through radioimmunoassay (RIA), serum/CSF ratios of titers were calculated in patients with normal pregnancies and in those with trophoblastic neoplasia. In normal pregnancies, the mean ratio of serum/CSF hCG was more than 45.5 +/- 6.0 (mean +/- SEM):1. In neoplasia without metastases to the brain, the ratio was more than 41.0:1. However, 2 patients with cerebral choriocarcinoma showed low ratios of 23.0:1 and 20.9:1, respectively. This suggests that determination of the beta-hCG concentration ratio of serum to CSF using RIA might give a more reliable evaluation for the early detection of choriocarcinoma metastasized to the brain.

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Section: Discussionmentioning

confidence: 99%

Radioimmunoassay of hCG as an Early Diagnosis of Cerebral Metastases in Choriocarcinoma Patients

Soma

Takayama

Tokoro

et al. 1980

Acta Obstet Gynecol Scand

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“…It is well‐known that many patients with brain metastases develop sudden neurological involvement due to intracranial hemorrhage, which is the most frequent mode of presentation and accounts for two‐thirds of the cerebral clinical manifestations (7) . In our case the principal neurologic presentation of brain metastases was sudden headache accompanied by sensory dysphasia.…”

Section: Discussionmentioning

confidence: 55%

Chemo-resistant choriocarcinoma cured by pulmonary lobectomy and craniotomy

Kang¹,

Lee²,

Kim³

et al. 2000

Int J Gynecol Cancer

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This is a case report of a 31 year-old female with choriocarcinomatous metastasis in brain and lung. Her serum beta-HCG level rose six times following normalization during 61 months of diverse multiagent systemic chemotherapy. Pulmonary lobectomy was done in March 1997 (57 months after initial diagnosis) due to persistent pulmonary nodule and poor response to chemotherapy. Histologic examination disclosed metastatic choriocarcinoma. However, her serum beta-HCG level did not normalize. Meanwhile, repeated measurement of beta-HCG concentration in cerebrospinal fluid was normal and imaging studies did not indicate evidence of metastasis. Sixty-one months after initial diagnosis fulminant intracerebral hemorrhage made emergency craniotomy mandatory. Histologic examination revealed metastatic choriocarcinoma. Serum beta-HCG levels returned to normal immediately after craniotomy and she reached complete remission after whole brain irradiation in January 2000. She is free of disease 91 months from initial diagnosis. The role of surgery in the treatment of patients with metastatic choriocarcinoma has been diminished by the responsiveness to chemotherapy. However, local resection of metastases still seems to play a significant role in controlling complications of gestational trophoblastic neoplasia and even in curing the disease in a small subset of patients.

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“…Choriocarcinoma may develop after any type of pregnancy (273) and occurs in about 1 in 50,000 deliveries (274). However, it has a predilection to invade blood vessels and may cause (i) infarction by local arterial occlusion (276) or by embolic arterial occlusion (277), (ii) intraparenchymal haemorrhage by invasion through a blood vessel wall (275,(278)(279)(280)(281) or (iii) SAH by formation of a metastatic arterial aneurysm (282)(283)(284). However, it has a predilection to invade blood vessels and may cause (i) infarction by local arterial occlusion (276) or by embolic arterial occlusion (277), (ii) intraparenchymal haemorrhage by invasion through a blood vessel wall (275,(278)(279)(280)(281) or (iii) SAH by formation of a metastatic arterial aneurysm (282)(283)(284).…”

Section: Pregnancy-specific Causes Of Strokementioning

confidence: 99%