Term delivery following successful treatment of choriocarcinoma with brain metastases, a case report and review of literature
- 159 Downloads
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.
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.
Multiagent EMA-EP chemotherapy and whole brain irradiation with craniotomy in selected patients preserves fertility and may improve a patient overall prognosis.
KeywordsChoriocarcinoma Brain metastases EMA-EP
- 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):235–238PubMedGoogle 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):763–768Google 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 PubMedCrossRefGoogle 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 PubMedCrossRefGoogle Scholar