Cerebral Metastases of a Choriocarcinoma During Pregnancy

Abstract

In Brief BACKGROUND Cerebral metastasis of choriocarcinoma during pregnancy is rare. Described is the fourth case in the literature. CASE A pregnant women at 28 weeks' gestation sought care for headaches followed by loss of consciousness. The diagnosis of choriocarcinoma metastases was made on the basis of the combination of cerebral and pulmonary lesions, all suspected to be metastatic, and a high β human chorionic gonadotropin level. A premature cesarean delivery was performed to improve the mother's prognosis; the responsiveness of choriocarcinoma to chemotherapy made it important for treatment to begin as rapidly as possible. The outcome has been on balance favorable, even though her sequelae include paraplegia. The child has no apparent sequelae. CONCLUSION The diagnosis of choriocarcinoma must be considered when acute neurological signs appear in a pregnant patient. Acute neurological signs in pregnant women require consideration of a diagnosis of choriocarcinoma and of emergency cesarean delivery to allow rapid treatment and improve maternal prognosis.