Cerebral metastasis prom choriocarcinoma and oncotic aneurysms: case report

Gallo, Pasquale; Fabião Neto, Othello M.; Raupp, Sérgio F.; Ordovas, Carlos A.; Oppitz, Paulo P.

doi:10.1590/S0004-282X1993000200023

Abstracts

Cerebral metastasis occur in 10 to 20% of patients with choriocarcinoma. We describe the twelfth patient with oncotic aneurysms from choriocarcinoma verified by cerebral angiography. The importance to consider this disease in a woman of childbearing age who develop an intracerebral hemorrhage or a lesion with mass effect is emphasized, as well as laboratorial and radiological characteristics. Therapeutic approaches with chemotherapic agents, surgery and irradiation are discussed.

choriocarcinoma; cerebral metastasis; oncotic aneurysm

Metástases cerebrais ocorrem em 10 a 20% das pacientes com coriocarcinoma. Apresentamos o décimo segundo relato na literatura mundial de paciente com aneurismas oncóticos, demonstrados na angiografia cerebral, secundários a metástases cerebrais de coriocarcinoma. A importância de se considerar esta patologia no diagnóstico dias lesões expansivas e/ou hemorrágicas cerebrais numa paciente em idade reprodutiva é salientada, bem como as características laboratoriais e radiológicas. O papel da quimioterapia, cirurgia e radioterapia no manuseio dessas metástases é discutido.

coriocarcinoma; metástase cerebral; aneurisma oncótico

Cerebral metastasis prom choriocarcinoma and oncotic aneurysms: case report

Metas tase cerebral de coriocarcinoma e aneurismas oncóticos: relato de caso

Pasquale Gallo; Othello M. Fabião Neto; Sérgio F. Raupp; Carlos A. Ordovas; Paulo P. Oppitz

Departament of Neurosurgery and Neuroradiology, Cristo Redentor Hospital, Porto Alegre

SUMMARY

Cerebral metastasis occur in 10 to 20% of patients with choriocarcinoma. We describe the twelfth patient with oncotic aneurysms from choriocarcinoma verified by cerebral angiography. The importance to consider this disease in a woman of childbearing age who develop an intracerebral hemorrhage or a lesion with mass effect is emphasized, as well as laboratorial and radiological characteristics. Therapeutic approaches with chemotherapic agents, surgery and irradiation are discussed.

Key words: choriocarcinoma, cerebral metastasis, oncotic aneurysm.

RESUMO

Metástases cerebrais ocorrem em 10 a 20% das pacientes com coriocarcinoma. Apresentamos o décimo segundo relato na literatura mundial de paciente com aneurismas oncóticos, demonstrados na angiografia cerebral, secundários a metástases cerebrais de coriocarcinoma. A importância de se considerar esta patologia no diagnóstico dias lesões expansivas e/ou hemorrágicas cerebrais numa paciente em idade reprodutiva é salientada, bem como as características laboratoriais e radiológicas. O papel da quimioterapia, cirurgia e radioterapia no manuseio dessas metástases é discutido.

Palavras-chave: coriocarcinoma, metástase cerebral, aneurisma oncótico.

Full text available only in PDF format.

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Aceite: 18-novembro-1992.

Dr. Pasquale Gallo Rua Tobias da Silva 99/203 - 90570-020 Porto Alegre RS - Brasil.

1. Bagshave KD, Harland S. Immunodiagnosis and monitoring of gonadotrophin-producing metastasis in the central nervous system. Cancer 1976, 38:112-118.
2. Begent RHJ, Bagshave KD. The management of high-risk choriocarcinoma. Semin Oncol 1982, 9:198-203.
3. Brace KC. The role of irradiation in the treatment of metastatic trophoblastic disease. Radiology 1968, 9:540-544.
4. Brewer JI, Halpern B, Torok EE, Gestational trophoblastic tumors. Cur Prob Cancer 1979, 3:4-9.
5. Case records of the Massachusetts General Hospital, case 16. N Engl J Med 1977, 296: 926-933.
6. Dagi TF, Maccabe JJ. Metastic trophoblastic disease presenting as a subarachnoid hemorrhage: report of two cases and review of the literature. Surg Neurol 1980, 14:175-184.
7. Delahunt B, Heng Teoh H, Balakrishnan V, Nacey JN, Clark SOP. Testicular germ cell tumor with pineal metastasis. Neurosurgery 1990, 26:688-691.
8. Fisher RG, Bennion S, Frimmer D, Malatesta RL. Metastic cerebral choriocarcinoma without pelvic or pulmonary metastasis. Surg Neurol 1979, 11:57-59.
9. Hongzhao S, Boazhen W. Brain metastasis in choriocarcinoma and malignant mole. Chin Med J 1979, 92:164.
10. Ishizuka T, Tomoda Y, Kaseki S, Goto S, Hara T, Kobayashi T. Intracranial metastasis of choriocarcinoma: a clinicopathological study. Cancer 1983, 52:1986-1903.
11. Jones WB. Gestational trophoblastic neoplasms. Surg Clin N Am 1978, 58:167-179.
12. Kobayashi T, Kida Y, Yoshida J, Shibuya N, Kageyama N. Brain metastasis of choriocarcinoma. Surg Neurol 1982, 17:395-403.
13. Kobayashi T, Yoshid J, Ishiyama J, Noda S, Kito A, Kida Y. Combination chemoterapy with cisplatin and etoposid for malignant germ-cell tumors. J Neurosurg 1989, 70:676-681.
14. Lukas DS. Embolismo pulmonar. In Wyngaardow JB, Smith LM Jr (eds): Cecil tratado de medicina interna. Rio de Janeiro: Interamericana, 1984, p 221.
15. Ma HK, Wong LC. Gestational trophoblastic disease in Hong Kong. Semin Oncol 1982, 9:224-233.
16. Monna F, Book H, Miyamoto T, Nagao S. Intracranial aneurysm due to metastatic choriocarcinoma. Surg Neurol 1986, 26:74-76.
17. Montaut J, Hepner H, Tridon P, Picard L, Floquet J, Lepoire J. Aspects pseudo-vasculaires des métastases intracraniennes des chorio-épitheliomes. Neurochirurgie 1971, 17:119-128.
18. O'Neill E, Pelegrina I, Hammond CB, Vicens R, Almodovar AR. Normal pregnancy and delivery after cerebral metastasis of choriocarcinoma. Cancer 1976, 38:984-986.
19. Seigle JM, Caputy AJ, Manz HJ, Wheeler C, Fox JL. Multiple oncotic intracranial aneurysms and cardiac metastasis from choriocarcinoma: case report and review of the literature. Neurosurgery 1987, 20:39-42.
20. Stilp TJ, Bucy PC, Brewer JI. Cure of metastatic choriocarcinoma of the brain. JAMA 1972, 221:276-279.
21. Weir B, MacDonald N, Mielke B. Intracranial vascular complications of choriocarcinoma. Neurosurgery 1978, 2:138-142.
22. Xu Z: Cerebral metastatic choriocarcinoma: analysis of 35 autopsies. Clin Med J 1982, 95:273-277.

Publication Dates

Publication in this collection
19 Jan 2011
Date of issue
June 1993

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Bagshave KD, Harland S. Immunodiagnosis and monitoring of gonadotrophin-producing metastasis in the central nervous system. Cancer 1976, 38:112-118.

[2] 2. Begent RHJ, Bagshave KD. The management of high-risk choriocarcinoma. Semin Oncol 1982, 9:198-203.

[3] 3. Brace KC. The role of irradiation in the treatment of metastatic trophoblastic disease. Radiology 1968, 9:540-544.

[4] 4. Brewer JI, Halpern B, Torok EE, Gestational trophoblastic tumors. Cur Prob Cancer 1979, 3:4-9.

[5] 5. Case records of the Massachusetts General Hospital, case 16. N Engl J Med 1977, 296: 926-933.

[6] 6. Dagi TF, Maccabe JJ. Metastic trophoblastic disease presenting as a subarachnoid hemorrhage: report of two cases and review of the literature. Surg Neurol 1980, 14:175-184.

[7] 7. Delahunt B, Heng Teoh H, Balakrishnan V, Nacey JN, Clark SOP. Testicular germ cell tumor with pineal metastasis. Neurosurgery 1990, 26:688-691.

[8] 8. Fisher RG, Bennion S, Frimmer D, Malatesta RL. Metastic cerebral choriocarcinoma without pelvic or pulmonary metastasis. Surg Neurol 1979, 11:57-59.

[9] 9. Hongzhao S, Boazhen W. Brain metastasis in choriocarcinoma and malignant mole. Chin Med J 1979, 92:164.

[10] 10. Ishizuka T, Tomoda Y, Kaseki S, Goto S, Hara T, Kobayashi T. Intracranial metastasis of choriocarcinoma: a clinicopathological study. Cancer 1983, 52:1986-1903.

[11] 11. Jones WB. Gestational trophoblastic neoplasms. Surg Clin N Am 1978, 58:167-179.

[12] 12. Kobayashi T, Kida Y, Yoshida J, Shibuya N, Kageyama N. Brain metastasis of choriocarcinoma. Surg Neurol 1982, 17:395-403.

[13] 13. Kobayashi T, Yoshid J, Ishiyama J, Noda S, Kito A, Kida Y. Combination chemoterapy with cisplatin and etoposid for malignant germ-cell tumors. J Neurosurg 1989, 70:676-681.

[14] 14. Lukas DS. Embolismo pulmonar. In Wyngaardow JB, Smith LM Jr (eds): Cecil tratado de medicina interna. Rio de Janeiro: Interamericana, 1984, p 221.

[15] 15. Ma HK, Wong LC. Gestational trophoblastic disease in Hong Kong. Semin Oncol 1982, 9:224-233.

[16] 16. Monna F, Book H, Miyamoto T, Nagao S. Intracranial aneurysm due to metastatic choriocarcinoma. Surg Neurol 1986, 26:74-76.

[17] 17. Montaut J, Hepner H, Tridon P, Picard L, Floquet J, Lepoire J. Aspects pseudo-vasculaires des métastases intracraniennes des chorio-épitheliomes. Neurochirurgie 1971, 17:119-128.

[18] 18. O'Neill E, Pelegrina I, Hammond CB, Vicens R, Almodovar AR. Normal pregnancy and delivery after cerebral metastasis of choriocarcinoma. Cancer 1976, 38:984-986.

[19] 19. Seigle JM, Caputy AJ, Manz HJ, Wheeler C, Fox JL. Multiple oncotic intracranial aneurysms and cardiac metastasis from choriocarcinoma: case report and review of the literature. Neurosurgery 1987, 20:39-42.

[20] 20. Stilp TJ, Bucy PC, Brewer JI. Cure of metastatic choriocarcinoma of the brain. JAMA 1972, 221:276-279.

[21] 21. Weir B, MacDonald N, Mielke B. Intracranial vascular complications of choriocarcinoma. Neurosurgery 1978, 2:138-142.

[22] 22. Xu Z: Cerebral metastatic choriocarcinoma: analysis of 35 autopsies. Clin Med J 1982, 95:273-277.