Brain metastasis of choriocarcinoma

Twenty-four patients with histologically verified brain metastasis of choriocarcinoma were analyzed regarding autopsy and operative findings, signs and symptoms, diagnosis, method of treatment, and prognosis. The autopsy incidence of brain metastasis was 66.7% in patients with choriocarcinoma, and the predominance of single brain lesions was confirmed. Most of the metastatic lesions were hemorrhagic. The hemorrhages were intratumoral, peritumoral, and/or subarachnoid. These findings were well correlated with the findings on computed tomographic (CT) scans and the acute onset with rapid progression of symptoms. The history of molar pregnancy, measurements of urinary chorionic gonadotropin, and findings on CT scans were diagnostic. Surgical removal of the lesion followed by chemotherapy combined with irradiation is the treatment of choice in patients with progressive neurological deterioration in whom chemotherapy alone is ineffective.