The Diagnosis And Treatment Of Choriocarcinoma Brain Metastases And One Case Report Of Choriocarcinoma Sellar Metastasis

Objective: To explore the generation and development mechanisms of brain metastasis of choriocarcinoma, to summarize the experience of diagnosis and treatment of brain metastasis from choriocarcinoma, and to provide references for the diagnosis and treatment of this disease for clinicians. Method: One case of patient admitted to The Zhongshan Hospital of Xiamen University was collected. It was pathologically confirmed to be brain metastasis of choriocarcinoma. We analyzed the clinical manifestations, pathology, laboratory examinations, diagnosis and treatment of brain metastases of choriocarcinoma on the basis of previous literatures. Results: The patient was female, aged 24 years old. The main symptoms were menopause, irregular vaginal bleeding and lower abdominal pain. The transvaginal ultrasound showed that the volume of uterine was normal, the muscular layer echo was uniform, the endometrial thickness was 3 mm and no pregnant bursa was in the uterine cavity. However an anechoic area was seen in the left adnexa uteri. MRI of the head: increased anteroposterior diameter of the sella, which was about 1.5cm. There was a mixed signal in the saddle area, the rang was about 2.5cmX2.3cmX2.0cm, the border was clear, and after enhanced it had a low signal. As the increased HCG levels in the blood, headache, vomiting, and the declining in vision, the neurosurgical surgery was taken. The tumor had a rich blood supply, and the border of which was clear. The harmonic scalpel was used in the surgery, the most of the tumor was removed. There was an intracranial hematoma during the operation, a craniectomy was taken at last. The pathology of the tumor was choriocarcinoma. Postoperative radiotherapy and chemotherapy were not taken, because of the poor condition of the body. Conclusion: Choriocarcinoma is a malignant form of gestational trophpblastic tumor. Due to hematogenic spread of trophoblastic tissue, the metastases are manifested very early, and their symptoms are usually related to bleeding from metastatic focus. With the development in medical technology, the prognosis of choriocarcinoma has been greatly improved. But the mortality of choriocarcinoma with brain metastases is still high. Early recognition of choriocarcinoma with brain metastases is essential in view of its threatening potential and high curability when treated early and comprehensive therapy.