Skip to main content

Advertisement

SpringerLink
Log in

Term delivery following successful treatment of choriocarcinoma with brain metastases, a case report and review of literature

  • Case Report
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Cerebral metastases from choriocarcinoma are a poor prognostic indicator of outcome in both the World Health Organization and FIGO classification systems. Although gestational trophoblastic neoplasia has become the most curable of gynecological malignancies, failure rate among “high-risk” patients is still high despite of the use of aggressive multidrug regimens.

Case

A 27-year-old woman (G4P2Ab1) presented with hemiplegia due to brain metastases of choriocarcinoma 1 year after spontaneous abortion. She underwent craniotomy and was treated with nine courses of multiple agent etoposide, methotrexate, actinomycin- etoposide, and cisplatinum (EMA-EP) regimen combined with whole brain irradiation. She delivered a term healthy child 2 years after termination of treatment.

Conclusion

Multiagent EMA-EP chemotherapy and whole brain irradiation with craniotomy in selected patients preserves fertility and may improve a patient overall prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hiramatsu Y, Masuyama H, Ishida M, Murakami K, Sakurai M (2005) Term delivery choriocarcinoma patient with brain and lung metastases successfully treated by etoposide, methotrexate, actinomycin D, cyclophosphamide and vincristin (EMA-CO) chemotherapy. Acta Med Okayama 59(5):235–238

    PubMed  Google Scholar 

  2. Jones WB, Wagner-Reiss KM, Lewis JL Jr (1991) Intracerebral choriocarcinoma. Gynecol Oncol 40(1):100

    Article  Google Scholar 

  3. Evans AC Jr, Soper JT, Clarke-Pearson DL, Berchuck A (1995) Central nervous system metastases of choriocarcinoma. 23 years’ experience at charing cross hospital. Gynecol Oncol 59(2):226–230. doi:10.1006/gyno.1995.0013

    Article  PubMed  Google Scholar 

  4. Ayhan A, Tuncer ZS, Tanir M, Erbengi A (1996) Central nervous system involvement in gestational trophoblastic neoplasia. Acta Obstet Gynecol Scand 75(6):548–550. doi:10.3109/00016349609054669

    Article  PubMed  CAS  Google Scholar 

  5. Soper JT, Hammond CB (1987) Role of surgical therapy and radiotherapy in gestational trophoblastic disease. J Reprod Med 32(9):663–668

    PubMed  CAS  Google Scholar 

  6. Semple PL, Denny L, Coughlan M, Soeters R, Van Wijk L (2004) The role of neurosurgery in the treatment of cerebral metastases from choriocarcinoma: a report of two cases. Int J Gynecol Cancer 14(1):157–161. doi:10.1111/j.1048-891x.2004.14147.x

    Article  PubMed  CAS  Google Scholar 

  7. Lurain JR (1998) Management of high-risk gestational trophoblastic disease. J Reprod Med 43(1):44–52

    PubMed  CAS  Google Scholar 

  8. Baertschi E, Notter M, Mironov A, Wernli M, Bargetzi MJ (2003) Cerebral metastasis in choriocarcinoma a case report. Schweiz Rundsch Med Prax 92(16):763–768

    CAS  Google Scholar 

  9. Amr MF (1999) Return of fertility after successful chemotherapy treatment of gestational trophoblastic tumors. Int J Fertil Womens Med 44(3):146–149

    PubMed  CAS  Google Scholar 

  10. Soper JT, Spillman M, Sampson JH, Kirkpatrick JP, Wolf JK, Clarke-Pearson DL (2007) High-risk gestational trophoblastic neoplasia with brain metastases: individualized multidisciplinary therapy in the management of four patients. Gynecol Oncol 104(3):691–694. doi:10.1016/j.ygyno.2006.10.027

    Article  PubMed  CAS  Google Scholar 

  11. Ghaemmaghami F, Modares M, Arab M, Behtash N, Moosavi AZ, Khanafshar N, Hanjani P (2004) EMA-EP regimen, as firstline multiple agent chemotherapy in high-risk GTT patients (stage II–IV). Int J Gynecol Cancer 14(2):360–365

    Article  PubMed  CAS  Google Scholar 

  12. Bower M, Rustin GJ, Newlands ES, Holden L, Short D, Foskett M et al (1998) Chemotherapy for gestational trophoblastic tumours hastens menopause by 3 years. Eur J Cancer 34(8):1204–1207. doi:10.1016/S0959-8049(98)00059-8

    Article  PubMed  CAS  Google Scholar 

  13. Suzuki I, Goto S, Yamada A, Tomoda Y (1993) Pregnancy after chemotherapy for trophoblastic diseases and psychosomatic development in the progeny. Asia Oceania J Obstet Gynaecol 19(4):407–415

    PubMed  CAS  Google Scholar 

  14. Goto S, Ino K, Mitsui T, Kikkawa F, Suzuki T, Nomura S et al (2004) Survival rates of patients with choriocarcinoma treated with chemotherapy without hysterectomy: effects of anticancer agents on subsequent births. Gynecol Oncol 93(2):529–535. doi:10.1016/j.ygyno.2004.02.018

    Article  PubMed  CAS  Google Scholar 

  15. Yokota H, Mabuchi Y, Hosomichi T, Kimura M, Imai H, Sutou K (1993) A case of successful pregnancy and delivery after brain metastasis of choriocarcinoma. Asia Oceania J Obstet Gynaecol 19(1):29–35

    PubMed  CAS  Google Scholar 

  16. Huang CY, Chen CA, Hsieh CY, Cheng WF (2007) Intracerebral hemorrhage as initial presentation of gestational choriocarcinoma: a case report and literature review. Int J Gynecol Cancer 17(5):1166–1171

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gynecology Oncology Department, Vali-e-Asr Hospital, Tehran University of Medical Sciences, 14194, Tehran, Iran

    Nadereh Behtash

  2. Kashan University of Medical Sciences, Kashan, Iran

    Fariba Behnamfar

  3. Gynecology Obstetrics Resident, Tehran University of Medical Sciences, Tehran, Iran

    Bahareh Hamedi

  4. Obstetrics Gynecology, Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Fatemeh Ramezanzadeh

Authors
  1. Nadereh Behtash
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fariba Behnamfar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bahareh Hamedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fatemeh Ramezanzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fariba Behnamfar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Behtash, N., Behnamfar, F., Hamedi, B. et al. Term delivery following successful treatment of choriocarcinoma with brain metastases, a case report and review of literature. Arch Gynecol Obstet 279, 579–581 (2009). https://doi.org/10.1007/s00404-008-0753-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-008-0753-x

Keywords

Search

Navigation