Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 23;6:740.
doi: 10.12688/f1000research.11681.1. eCollection 2017.

Case Report: Multiple Hemorrhagic Metastases to the Brain From Primary Lung Choriocarcinoma

Affiliations
Free PMC article

Case Report: Multiple Hemorrhagic Metastases to the Brain From Primary Lung Choriocarcinoma

Sunil Munakomi. F1000Res. .
Free PMC article

Abstract

Herein we report a very rare entity of multiple hemorrhagic metastases to the brain from a primary lung choriocarcinoma in a young woman. The patient presented with recent onset of progressive headache, decreased level of consciousness and multiple episodes of vomiting. CT of the head revealed multiple hemorrhagic lesions within the brain. The patient's serum B-human chorionic gonadotrophin was increased. A chest X-ray revealed a right lung mass. The patient urgently underwent operative excision of the lesion in the posterior fossa, so as to prevent impending tonsillar herniation. The histology from the lesion provided the diagnosis of choriocarcinoma. After surgery, ultrasonography of the abdomen and pelvis was normal, and a chest CT revealed an enhanced and highly vascular right apical lung lesion, suggestive of lung primary choriocarcinoma, with regard to the clinical background. The patient was then started on chemotherapy, following which her serum B-HCG level decreased rapidly. This case highlights the importance of keeping this entity in the differential diagnosis of hemorrhagic lesions in any patients of a child bearing age. Early diagnosis and rapid initiation of multimodal therapy is prudent for ensuring a good outcome from an otherwise rapidly metastasizing and highly vascular lesion.

Keywords: brain; choriocarcinoma; lung; metastasis; primary.

Conflict of interest statement

Competing interests: No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Clinical image showing bilateral sixth nerve palsy in the patient.
Figure 2.
Figure 2.. CT head images showing multiple hemorrhagic lesions within the brain.
Figure 3.
Figure 3.. MRI images showing multiple lesions within the brain at different phase of resolution.
Figure 4.
Figure 4.. MRI angiography showing absence of any vascular blush or major arterial feeder to the lesions.
Figure 5.
Figure 5.. Chest X-ray revealing right sided apical lung lesion.
Figure 6.
Figure 6.. Post-operative CT image showing complete excision of the lesion in the posterior fossa.
Figure 7.
Figure 7.. Histology image confirming the diagnosis of invasive choriocarcinoma.
Figure 8.
Figure 8.. CT chest confirming presence of an enhanced and highly vascular lesion in the upper lobe of the right lung.

Similar articles

See all similar articles

References

    1. Rhee YK, Kim JH, Kim WH, et al. : Primary choriocarcinoma of the lung. Korean J Intern Med. 1987;2(2):269–272. 10.3904/kjim.1987.2.2.269 - DOI - PMC - PubMed
    1. Umemori Y, Hiraki A, Aoe K, et al. : Primary choriocarcinoma of the lung. Anticancer Res. 2004;24(3b):1905–1910. - PubMed
    1. Tanimura A, Natsuyama H, Kawano M, et al. : Primary choriocarcinoma of the lung. Hum Pathol. 1985;16(12):1281–1284. 10.1016/S0046-8177(85)80045-9 - DOI - PubMed
    1. Snoj Z, Kocijancic I, Skof E: Primary pulmonary choriocarcinoma. Radiol Oncol. 2017;51(1):1–7. 10.1515/raon-2016-0038 - DOI - PMC - PubMed
    1. Vegh GL, Szigetvári I, Soltesz I, et al. : Primary pulmonary choriocarcinoma: a case report. J Reprod Med. 2008;53(5):369–72. - PubMed

Grant support

The author(s) declared that no grants were involved in supporting this work.

LinkOut - more resources

Feedback