Spontaneous intracerebral haemorrhage as an initial presentation of a choriocarcinoma

Mustafa, Maher Khashea; Matti, Wamedh E; Kadhum, Hussain J.; Alsubaihawi, Zahraa A.; Kareem, Zahraa M.; Al-Sharshahi, Zahraa F.; Hoz, Samer S.

doi:10.33962/roneuro-2021-008

Cited by 3 publications

(7 citation statements)

References 11 publications

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“…Table 1 shows the productivity of Iraqi medical students with their publications’ number and type of authorship. [ 2 - 12 , 15 - 25 , 28 , 31 - 37 , 39 - 43 , 45 - 61 , 63 , 65 , 67 - 69 , 72 , 73 ]…”

Section: Resultsmentioning

confidence: 99%

Academic productivity of Iraqi medical students in the field of neurosurgery: A literature review

Ismail

Algburi

Al-Khazaal

et al. 2023

Surgical Neurology International

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Background: The interest in clinical research is growing worldwide, and the involvement of medical students in academic and clinical research is increasing. Medical students in Iraq have started to focus on academic activities. However, this trend is in its infancy due to limited resources and the war burden. Their interest in the field of Neurosurgery has been evolving recently. This is the first paper that aims to assess the status of the academic productivity of Iraqi medical students within the neurosurgical field. Methods: We searched the PubMed Medline database and Google scholar between January 2020 and December 2022 with a different combination of keywords. Additional results were obtained by individually searching for all the medical universities in Iraq that participated in the neurosurgical literature. Results: Between January 2020 and December 2022, 60 neurosurgical publications included Iraqi medical students. 47 Iraqi medical students from 9 universities (the University of Baghdad 28 students, followed by 6 students from the University of Al-Nahrain, and others) were involved in these 60 neurosurgery publications. The topics of these publications are “vascular neurosurgery” (n = 36) followed by “neurotrauma” (n = 11). Conclusion: Academic productivity of Iraqi medical students in the field of Neurosurgery has surged in the last 3 years. In the past 3 years, 47 Iraqi medical students from nine different Iraqi universities contributed to sixty international neurosurgical publications. However, there are challenges that are required to be tackled to establish a research-friendly environment despite wars and restrained resources.

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Section: Resultsmentioning

confidence: 99%

Academic productivity of Iraqi medical students in the field of neurosurgery: A literature review

Ismail

Algburi

Al-Khazaal

et al. 2023

Surgical Neurology International

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“…[15] Considering all postmolar choriocarcinoma cases explained in Table 1, most had synchronous lung and renal metastasis. However, Mustafa et al [11] depicted a multi-organ metastatic involvement, including a single kidney, without lung metastasis, and lung metastasis also occurred after nephrectomy in Karadeniz et al [5] report. Similarly, in our case, solitary kidney metastasis happens without lung metastasis.…”

Section: Discussionmentioning

confidence: 98%

“…[3, 5, 10] There were four cases of developing postmolar choriocarcinoma after hydatiform mole hysterectomy treatment. [3,5,8,10] Excluding patients who underwent a hysterectomy, the primary uterine tumor was detected in only the two reports of Kutcher et al [7] and Mustafa et al [11]. Finally, all patients received chemotherapy and underwent appropriate additional treatment according to the location of the metastases, such as a hysterectomy, nephrectomy, oophorectomy, and brain hematoma evacuation.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, among pieces of postmolar choriocarcinoma renal involvement, there was no evidence of SRH, and the nephrectomy was performed to control the massive gross hematuria. [5,9,11] In light of these ndings, the β-hCG screening might help identify SRH cause or exclude the probable choriocarcinoma in such cases. [4,14] The noticeable strength of this study was describing a unique case of post-molar metastatic choriocarcinoma to a single kidney without the other common sites of metastasis and primary tumor in the uterus that only presented with urologic symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, choriocarcinoma renal metastasis is extremely rare, with 1-6.9% incidence. [2][3][4][5][6] A couple of previous reports described postmolar choriocarcinoma renal metastasis that presented with a wide variety of symptoms due to synchronous involvement of the common site of choriocarcinoma metastasis [3,5,[7][8][9][10][11][12], and only a few patients had pure urologic symptoms, such as hematuria. [5,7,9] In light of these ndings, post-molar choriocarcinoma with renal metastasis is scarce and not described frequently in previous reports, especially with the pure urologic presentation.…”

Section: Introductionmentioning

confidence: 99%

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Postmolar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: A case report and review of the literature

Geravandi

Hajihashemi

Adibi

et al. 2023

Preprint

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Background: Choriocarcinoma is a rare high malignant type of gestational trophoblastic disease (GTD) that occurs after pregnancies, abortions, or hydatiform moles and seldom metastasizes to the kidneys. Postmolar choriocarcinoma with renal metastasis is also scarce and was not frequently described. Here, we depicted the first case of postmolar choriocarcinoma with solitary kidney metastasis presenting with spontaneous renal hemorrhage (SRH) in the absence of a primary uterine tumor. Case presentation: A 41-year-old female patient with a history of complete molar pregnancy was evaluated due to severe flank pain, nausea/vomiting, gross hematuria, and vaginal bleeding in the last three weeks. The evaluations demonstrated bilateral pleural effusion without any lesion within the lungs, an empty uterine cavity, and a left kidney lower pole lesion with active bleeding surrounded by hematoma, alongside a serum β-hCG level of 60,000 mIU/mL. According to these findings, laparotomy exploration was planned and ended with a partial nephrectomy, para ovarian cystectomy. In addition, endometrial curettage was performed. The histopathology results revealed choriocarcinoma renal metastasis with high expression of β-hCG, cytokeratin, cytokeratin7, and KI67. In addition, a corpus luteum cyst was found within the left ovarian cyst, and endometrial curettage showed a progestin agent effect without malignant cells. Moreover, the brain, liver, and adrenal glands were not involved with metastases, and the pleural effusion fluid was free of malignant cells. Finally, the patient was referred to the oncology department to receive chemotherapy, and the β-hCG level dropped to 5 mIU/mL after receiving courses of a standard EMA-CO regimen (etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine/oncovin) over three weeks. Conclusions: Postmolar metastatic choriocarcinoma might present only urologic symptoms, such as hematuria and SRH, due to metastatic renal involvement. Indeed, considering choriocarcinoma and evaluating the serum β-hCG level among childbearing-aged females with unexplained urological symptoms could be advantageous, particularly when a previous molar pregnancy exists.

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Post molar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: a case report and review of the literature

Geravandi,

Hajihashemi,

Adibi

et al. 2024

J Med Case Reports

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Background Choriocarcinoma is a rare and highly malignant form of gestational trophoblastic disease that may develop following pregnancy, abortion, or a hydatiform mole. Renal metastatic involvement by post molar choriocarcinoma is even rarer. In this case report, we describe a unique case of post molar choriocarcinoma with a solitary renal metastasis in the absence of a primary uterine tumor and metastases in other sites, which presented with urological symptoms and spontaneous renal hemorrhage. Case presentation A 41-year-old Persian woman with history of complete hydatiform mole presented with severe flank pain, nausea, vomiting, gross hematuria, and vaginal bleeding. Laboratory tests demonstrated a serum beta human chorionic gonadotropin hormone level of 60,000 mIU/mL. Imaging studies showed a lesion at the lower pole of the left kidney with active bleeding surrounded by hematoma, as well as an empty uterine cavity. Additionally, bilateral pleural effusion was detected without any lesion within the lungs. Subsequently, the patient underwent laparotomy, partial nephrectomy, and left para-ovarian cystectomy. Endometrial curettage was also carried out. The histopathology report revealed choriocarcinoma renal metastasis with high expression of beta human chorionic gonadotropin, cytokeratin 7, and Ki 67. Moreover, there were no malignant cells in the endometrial curettage specimens, and a corpus luteum cyst was found within the para-ovarian cyst. Further investigations revealed that the pleural effusion was free of malignant cells, and there was no evidence of metastatic lesions in the brain. As a result, the patient was referred to the oncology department to receive chemotherapy, and the beta human chorionic gonadotropin levels dropped to 5 mIU/mL after receiving courses of a standard regimen of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine/oncovin over 3 weeks. Finally, monthly measurements of beta human chorionic gonadotropin levels for 6 months indicated that levels have constantly remained within normal ranges, showing no evidence of recurrence or new metastasis. Conclusions Urological symptoms such as hematuria or spontaneous renal hemorrhage might be the only presentation of post molar choriocarcinoma with renal involvement. Thus, it can be beneficial to measure serum beta human chorionic gonadotropin levels among females of childbearing age who present with unexplained urological symptoms, especially if there is a history of prior hydatiform mole.

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Spontaneous intracerebral haemorrhage as an initial presentation of a choriocarcinoma

Cited by 3 publications

References 11 publications

Academic productivity of Iraqi medical students in the field of neurosurgery: A literature review

Academic productivity of Iraqi medical students in the field of neurosurgery: A literature review

Postmolar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: A case report and review of the literature

Post molar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: a case report and review of the literature

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