Successful treatment of multisite hemorrhage by several methods in brain metastasis of choriocarcinoma

Ren, Zhen; Yu, Li; Xie, Mengnv; Liang, Yongfeng; Zhu, Fang; Huang, Rui; Zhang, Zhibang; Fu, Chun

doi:10.1097/md.0000000000010794

Cited by 4 publications

(5 citation statements)

References 14 publications

(17 reference statements)

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“…Choriocarcinoma has a markedly tendency of early metastasis, just like what we found in this case, although vaginal bleeding is the common symptom of choriocarcinoma. [ 5 ] In this case presenting no vaginal bleeding, but spinal oppressive symptoms, the spine metastases were very rare compares to common lung metastases. [ 6 , 7 ] Table 1 presents all cases of reported choriocarcinoma metastases to the spine up to date.…”

Section: Discussionmentioning

confidence: 94%

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

Liu

Sun

et al. 2023

Medicine

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Rationale: Choriocarcinoma is a highly invasive gestational trophoblastic neoplasm, usually metastasis to lung and brain, but occurrence of choriocarcinoma following spontaneous abortion presenting as a vertebral tumor is extremely rare, to the best of our knowledge. Because of the poor diagnosis and high malignancy, the low progression-free survival follows up. Patient concerns: We here are reporting a case of choriocarcinoma that presented with vertebral tumor induced paralysis of limbs and incontinence of urine. Diagnosis: Combined with the childbearing history, high β-human chorionic gonadotrophinin levels, and imaging examination, a clinical diagnosis was made exactly. Till the pathological results after the operation of lumbar spinal canal tumorectomy, the diagnosis was exactly clear. Interventions: After performing the laminectomy, the fierce bleeding follows up, just did the temporary limited decompression. Because of the vertebral artery embolization, lumbar spinal canal tumorectomy, spinal canal and root canal decompression, subdural decompression and hematoma removal were performed. Outcomes: After performing the operation and chemotherapy timely and positively, the patient lost consciousness and died due to the pulmonary embolism at last. Lessons: This is the first case report describing choriocarcinoma with metastases to the spine amongst Chinese population as well. Early metastasis is one of the marked tendencies of choriocarcinoma, but spine metastasis and the related spinal oppressional symptoms were found instead of vaginal bleeding in this case, which is indeed rare.

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Section: Discussionmentioning

confidence: 94%

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

Liu

Sun

et al. 2023

Medicine

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“…The incidence of brain metastasis is approximately 8.8-66.7% [2][3][4]. Some studies have reported the occurrence of intracranial hemorrhage [5][6][7] and subarachnoid hemorrhage after the formation of aneurysms due to the vascularity of the lesion [8][9][10]. Furthermore, when rebleeding occurs, the outcome is even poorer [10].…”

Section: Discussionmentioning

confidence: 99%

“…However, the rate of brain metastasis of choriocarcinoma is relatively high [2][3][4]. Because of its vascularity, there have been some reports of cerebral hemorrhage and aneurysm formation related to brain metastasis of choriocarcinoma [5][6][7][8][9][10]. Furthermore, when rebleeding occurs, the outcome is even worse [10], and early diagnosis and treatment are extremely important to achieve a good outcome.…”

Section: Introductionmentioning

confidence: 99%

A Case of Metastatic Choriocarcinoma With Intracerebral Hemorrhage Caused by a Ruptured Pseudoaneurysm

Kondo¹,

Kiura²,

Magaki³

et al. 2023

Cureus

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A rare cause of cerebral hemorrhage is the metastasis of choriocarcinoma from gynecology. Herein, we report a case of a patient with brain metastasis of choriocarcinoma with cerebral hemorrhage. A 14-year-old female who had undergone surgery for a hydatidiform molar pregnancy presented with a disturbance of consciousness due to cerebral hemorrhage. Imaging studies revealed the presence of a cerebral aneurysm and several mass lesions in the lung field, and high serum beta-human chorionic gonadotropin level was confirmed. Thus, we suspected cerebral hemorrhage caused by brain metastasis of choriocarcinoma. She went into a coma, and an emergency craniotomy was performed to remove the hematoma and aneurysm. The pathology of the aneurysm was pseudoaneurysm due to the rupture of the vascular wall caused by increasing metastatic cells from choriocarcinoma in the cerebrovascular wall. Therefore, multidrug chemotherapy was immediately initiated. The choriocarcinoma, including the metastatic lesions, is in remission. To improve the outcome of choriocarcinoma, it must be diagnosed early, and treatment should be immediately started. Moreover, neurosurgeons should be aware of such diseases and consider them as one of the differential diagnoses, particularly in females of reproductive age with cerebral hemorrhage.

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“…The prognosis of choriocarcinoma with brain metastasis is dangerous and is the leading cause of death. They are usually accompanied by lung metastasis or vaginal metastasis [6].The initial stage of metastasis is mostly asymptomatic. Brain metastasis is divided into 3 stages.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Choriocarcinoma is highly malignant and metastasizes early. Before the advent of chemotherapy drugs, the mortality rate was over 90% [2,3].The primary treatment method of choriocarcinoma is chemotherapy [5,6]. The appropriate plan is determined by staging and grading, and the comprehensive treatment of surgery and radiotherapy is appropriately coordinated.…”

Section: Discussion/conclusionmentioning

confidence: 99%

A Case of Pregnancy with Choriocarcinoma Complicated by a Cerebral Hemorrhage and Lung Metastasis

Ren

Chen

et al. 2021

Case Rep Oncol

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Pregnancy with choriocarcinoma is a rare tumor. It is rare for neonates to survive the third trimester. This article reports the clinical data of a live fetal pregnancy with choriocarcinoma complicated by brain and lung metastases. The patient was admitted to the hospital for “menopause 28 weeks + 5 days, dizziness with nausea and vomiting 2 days.” After 5 hours of admission, the patient had sudden convulsions, urinary incontinence, and coma. A head computed tomography (CT) examination in the emergency department revealed a cerebral hemorrhage in the right occipital lobe and broke into the ventricular system with brain herniation. She was immediately transferred to the intensive care unit for the emergency cesarean section and intracerebral hematoma removal. A postoperative CT scan revealed that the tumor in the upper lobe of the right lung was considered lung cancer, with multiple metastases in both lungs. Postoperative pathology was metastatic choriocarcinoma tissue seen in the blood clot. Based on the pathological diagnosis of choriocarcinoma, a chemotherapy regimen was developed with 2 courses of EP regimen and 8 courses of combined EMA-CO chemotherapy regimen. The patients were followed up for 2 years and ultimately resolved.

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Successful treatment of multisite hemorrhage by several methods in brain metastasis of choriocarcinoma

Abstract: The diagnosis of choriocarcinoma may be difficult, especially in the setting with the limit of medical resources. The application of various diagnostic techniques such as x-ray, computed tomography, and magnetic resonance imaging is helpful for evaluating the patient's condition.

Cited by 4 publications

References 14 publications

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

Choriocarcinoma masquerading as lumbar spinal tumor: Case report and literature review

A Case of Metastatic Choriocarcinoma With Intracerebral Hemorrhage Caused by a Ruptured Pseudoaneurysm

A Case of Pregnancy with Choriocarcinoma Complicated by a Cerebral Hemorrhage and Lung Metastasis

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