PMID- 33130006
OWN - NLM
STAT- MEDLINE
DCOM- 20210430
LR  - 20210430
IS  - 1873-4332 (Electronic)
IS  - 1083-3188 (Linking)
VI  - 34
IP  - 1
DP  - 2021 Feb
TI  - Choriocarcinoma Presenting as Recurrent Intracranial Hemorrhage in an Adolescent 
      Patient.
PG  - 106-108
LID - S1083-3188(20)30348-X [pii]
LID - 10.1016/j.jpag.2020.10.005 [doi]
AB  - BACKGROUND: Due to its highly metastatic and invasive nature, choriocarcinoma may 
      affect other organ systems and mimic conditions not typical of gynecologic 
      cancers. Recurrent intracranial hemorrhage secondary to rupture of multiple 
      oncotic aneurysms is one of its rare initial presentations. CASE: We report a 
      2-month postpartum, 16-year old girl who initially presented with sudden-onset 
      left-sided weakness. Her plain cranial computed tomography scan showed a 16-mL 
      hematoma in the right parietal area, and her 4-vessel angiogram (4VA) disclosed 4 
      saccular aneurysms in bilateral distal middle cerebral arteries (MCA). The 
      beta-human chorionic gonadotrophin (beta-hCG) done 2 weeks later was 356,684.5 mIU, and 
      her transvaginal ultrasound showed an ill-defined heterogenous myometrial mass 
      measuring 1.6 x 1.3 x 1.2 cm. Due to the multiplicity of aneurysms and the 
      patient's young age, surgical excision and brain irradiation were deferred. 
      Nonetheless, she received chemotherapy with a regimen of etoposide, methotrexate, 
      actinomycin-D, cyclophosphamide, and vincristine/oncovin. SUMMARY AND CONCLUSION: 
      Early consideration of oncotic aneurysm secondary to choriocarcinoma in a 
      postpartum presenting with multiple intracranial hemorrhages may lead to earlier 
      administration of proper chemotherapy and, in turn, to a better prognosis. Age 
      and the number of aneurysms should be considered in choosing the appropriate 
      therapy.
CI  - Copyright (c) 2021 North American Society for Pediatric and Adolescent Gynecology. 
      Published by Elsevier Inc. All rights reserved.
FAU - Prado, Mario B Jr
AU  - Prado MB Jr
AD  - Section of Adult Neurology, Department of Neurosciences, College of Medicine and 
      Philippine General Hospital, University of the Philippines-Manila, Manila, 
      Philippines. Electronic address: mbprado@alum.up.edu.ph.
FAU - Adiao, Karen Joy
AU  - Adiao KJ
AD  - Section of Adult Neurology, Department of Neurosciences, College of Medicine and 
      Philippine General Hospital, University of the Philippines-Manila, Manila, 
      Philippines.
LA  - eng
PT  - Case Reports
DEP - 20201029
PL  - United States
TA  - J Pediatr Adolesc Gynecol
JT  - Journal of pediatric and adolescent gynecology
JID - 9610774
RN  - 0 (Chorionic Gonadotropin, beta Subunit, Human)
SB  - IM
MH  - Adolescent
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Choriocarcinoma/diagnostic imaging/drug therapy/*pathology
MH  - Chorionic Gonadotropin, beta Subunit, Human/blood
MH  - Female
MH  - Hematoma/diagnostic imaging/etiology
MH  - Humans
MH  - Intracranial Hemorrhages/diagnostic imaging/etiology
MH  - Postpartum Period
MH  - Tomography, X-Ray Computed
MH  - Ultrasonography
MH  - Uterine Neoplasms/diagnostic imaging/drug therapy/*pathology
OTO - NOTNLM
OT  - Adolescent
OT  - Choriocarcinoma
OT  - Oncotic aneurysm
OT  - Postpartum
EDAT- 2020/11/02 06:00
MHDA- 2021/05/01 06:00
CRDT- 2020/11/01 20:30
PHST- 2020/08/12 00:00 [received]
PHST- 2020/10/09 00:00 [revised]
PHST- 2020/10/23 00:00 [accepted]
PHST- 2020/11/02 06:00 [pubmed]
PHST- 2021/05/01 06:00 [medline]
PHST- 2020/11/01 20:30 [entrez]
AID - S1083-3188(20)30348-X [pii]
AID - 10.1016/j.jpag.2020.10.005 [doi]
PST - ppublish
SO  - J Pediatr Adolesc Gynecol. 2021 Feb;34(1):106-108. doi: 
      10.1016/j.jpag.2020.10.005. Epub 2020 Oct 29.