Lumbar Metastasis of Choriocarcinoma

Naito, Yohei; Akeda, Koji; Kasai, Yuichi; Matsumine, Akihiko; Tabata, Tsutomu; Nagao, Kazuharu; Uchida, Atsushi

doi:10.1097/brs.0b013e3181a98746

Cited by 18 publications

(26 citation statements)

References 12 publications

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“…The lung and brain have been described as the most common sites for metastasis in the literature 1,2,4,11,12,15,20,21,23,25) . Yet, metastasis in the musculoskeletal system, such as the spine, is extremely rare and this can be seen from the scant reported cases 4,[14][15][16]20,21) . This current report presents an unusual metastatic choriocarcinoma in the lumbar spine and it extended to the epidural space.…”

Section: Discussionmentioning

confidence: 99%

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

Lee

Park

Chung

et al. 2010

J Korean Neurosurg Soc

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We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

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Section: Discussionmentioning

confidence: 99%

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

Lee

Park

Chung

et al. 2010

J Korean Neurosurg Soc

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“…The spinal metastasis of choriocarcinoma is extremely rare11). Four cases of metastasis to the lumbar vertebral column and 2 cases to the epidural space have been reported3,6,7,10,11,14). To the best of our knowledge, no cases of metastasis in the intramedullary spinal cord have been reported in the literature.…”

Section: Introductionmentioning

confidence: 89%

“…The most common sites for metastasis are the vulvo-vaginal region, the lungs, the liver and the brain3,5,9,10). The spinal metastasis of choriocarcinoma is extremely rare11). Four cases of metastasis to the lumbar vertebral column and 2 cases to the epidural space have been reported3,6,7,10,11,14).…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Spinal Cord Metastasis of Choriocarcinoma

Heon

Lee

et al. 2012

J Korean Neurosurg Soc

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The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

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“…These lesions could be mistaken radiologically for hepatic vascular lesion as in the present case. The metastatic site being the presenting symptom in many cases, with the primary site being either too small or burnt out, often ruling out the diagnosis of choriocarcinoma [2, 5, 6, 10]. Thrombo embolic involvement is a known occurrence in choriocarcinoma both during therapy or after therapy [11–13].…”

Section: Discussionmentioning

confidence: 99%

“…Proposed pathogenesis suggested by the author was an increased paraneoplastic stimulus of HCG, secondary to the marker surge phenomenon leading to hypercoagulability and thus subsequent thromboembolism [13]. Bony metastasis secondary to choriocarcinoma are very rare, as is evidenced by very few studies in [2, 5, 10]. Bone marrow involvement rather than bone is almost not heard of and therefore no citations appear in the literature to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

ecancermedicalscience

Singh

Sardhana

Sharma

et al.

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Gestational trophoblastic diseases (GTD) are a heterogenous group of disorders that arise from trophoblastic epithelium. They can follow molar pregnancy (50%), abortions (25%), normal pregnancy (22.5%), and ectopic pregnancy (2.5%) [Robert JK, Lora HE, Brigitte MR (ed) Blaustein Pathology of the Female Genital Tract 6th edn (Springer) pp. 1101–7]. Occurrence of choriocarcinoma following normal delivery presenting as an isolated bone marrow metastasis is extremely rare, and no case has been cited in the literature, to the best of our knowledge. We are reporting a case of choriocarcinoma that presented with isolated bone marrow metastasis only.

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Lumbar Metastasis of Choriocarcinoma

Cited by 18 publications

References 12 publications

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

Intramedullary Spinal Cord Metastasis of Choriocarcinoma

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