Gestational Choriocarcinoma with Brain Metastases : A Clinical Analysis

Abstract

This report reviews the clinical features of 14 choriocarcinoma patients with brain metastases treated from 1986 to 1990 at the University of Texas MD An derson Cancer Center. The incidence is 5.3% of 264 gestational trophoblastic tumor patients. Brain metastases occurred after term delivery, abortion and hydatidiform mole in 9, 3, and 2 patients respectively. The group of term deliveries had a longer interval than the other two groups. Seven patients (50%) presented with neurological signs or symptoms, only one patient was asymptomatic. Five patients developed brain metastases during or after treatment with first line drugs. Abnormal serum : cerebro spinal fluid hCG ratio (less than 60 : 1) were found in only 3 patients (21%). Thir teen of 14 patients (93%) had accompanying pulmonary metastases. Brain metastases occurred equally in both cerebral hemispheres. The average modified WHO score was 15.2 (range 7-22). (Thai J Obstet Gynaecol 1991;3:31-37.)