Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
DECEMBER 2012
Next Case of the Month coming January 1...
Metastatic Choriocarcinoma
- Choriocarcinoma is a malignant proliferation of trophoblasts that complicates a normal or abnormal pregnancy.
- Intraparenchymal brain metastases from choriocarcinoma occur in 10-20 % of the cases and are often haemorrhagic.
- Endovascular metastases may lead to aneurysms by cell invasion of the vessel wall, with resultant progressive weakening and deformation.
- Neoplastic aneurysms have poor prognosis, with a mortality rate of 50%.
- Key Diagnostic Features: Hemorrhagic metastases with aneurysms. Elevated β-HCG in patients with diagnosis of choriocarcinoma should raise a red flag for associated complications (such as metastatic choriocarcinoma).
- DDx: Mycotic aneurysms
- Rx: Chemotherapy for metastatic disease. Aneurysms: endovascular or surgery
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