Brain metastases of gestational trophoblastic tumor

Brain involvement by gestational trophoblastic tumor (GTT) was diagnosed by computed tomography in 23 (17%) of 131 patients with metastatic GTT at King Faisal Specialist Hospital and Research Centre between January 1980 and December 1990. All 23 patients had concurrent lung involvement, and 20 presented with neurologic symptoms. There were three treatment groups: Group A--methotrexate, actinomycin-D, chlorambucil and brain irradiation; group B--cisplatin, VP-16, actinomycin-D and intrathecal methotrexate; and group C--palliative therapy and other chemotherapy. While no patients in groups A or C survived, 4 (57%) of 7 patients in group B achieved complete, sustained remission. Serum:cerebrospinal fluid beta-human chorionic gonadotropin ratios were measured in 9 patients and were < 60 in only 4 patients. The clinical features of patients with brain metastases are reviewed in detail.