Primary choriocarcinoma of the renal pelvis presenting as intracerebral hemorrhage: a case report and review of the literature

Abstract

IntroductionA 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.Case presentationWe 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.ConclusionExtragonadal 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.

Prolonged Remission of Upper Urinary Tract Urothelial Carcinoma With Prominent Choriocarcinomatous Differentiation: A Case Report

“…4, 7–10 One study found that 9 out of 47 high-grade urothelial neoplasms expressed hCG on immunohistochemistry, and two of these tumors demonstrated trophoblastic-like differentiation. 9 Alternatively, choriocarcinomas may originate from multipotent embryonal cells that became arrested during migration in ectopic locations.…”

“…4–11 Many of these tumors are thought to arise from trophoblastic (choriocarcinomatous) differentiation of high-grade urothelial carcinoma. 4, 7–10 Herein, we describe a male patient with choriocarcinoma of the renal pelvis, likely of urothelial origin, who was successfully treated with nephrectomy followed by multiple sequential chemotherapy regimens.…”

Brain metastases of choriocarcinoma: A report on two cases

“…The risk of choriocarcinoma is rare before the age of 20 years, and it is significantly increased in individuals over 40 years 5 . Both presented cases are beyond typical etiology of choriocarcinoma.…”

Choriocarcinoma of unknown origin with multiple organ metastasis and cerebral hemorrhage: A case report and literature review

“…The disease is extremely rare, particularly in male patients, and there are few studies on such cases (2). The present study reports the case of a 26-year-old male patient with choriocarcinoma, providing a firsthand opportunity to review the specific features of the disease, including rapid and multiple metastasis, a high level of β-HCG, and the associated life-threatening effects.…”