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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Choriocarcinoma is a potentially curable neoplasm. Although the presence of intracranial metastases worsens the ultimate prognosis, several reports have shown successful response to therapy. This clinical report outlines a method by which the appropriate therapy may be initiated in a patient with intracranial metastases, who otherwise may not have survived the interval necessary for the induction of successful therapy.
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PMID:Choriocarcinoma with brain metastases. Successful management of increased intracranial pressure with barbiturates. 394 24

Choriocarcinoma commonly presents with symptoms resulting from metastases in the lungs, central nervous system, or alimentary tract. This tumour may occur without any gynaecological symptoms and when pelvic examination and uterine curettage show no abnormality. Several years may elapse between the antecedent pregnancy and presentation with metastatic disease. The ability to eradicate these tumours with present chemotherapeutic methods depends on detecting their presence as soon as possible after the antecedent pregnancy.Wider recognition of the varied manifestations of metastatic choriocarcinoma and greater use of tests for chorionic gonadotrophin should result in earlier diagnosis and an improved prognosis in these patients. In particular, such tests should be made in patients with unexplained intracranial haemorrhage, progressive dyspnoea, and gastrointestinal haemorrhage.
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PMID:Medical presentations of choriocarcinoma. 531 64

Choriocarcinoma is known to be sensitive to chemotherapy. Remission rates of 70% are reported for patients with metastatic disease. The Southeastern Regional Trophoblastic Disease Center of Duke University has reviewed its experience with the treatment of cerebral metastases from choriocarcinoma. Fourteen patients were identified as having cerebral metastases from a group of more than 500 patients with gestational trophoblastic disease (GTD) other than primary hydatidiform mole. The remission rate of 50% (7/14) was achieved by vigorous, multiagent chemotherapy and combined cerebral irradiation therapy. This series of patients is reviewed with regard to diagnosis, details of multiagent chemotherapy with cerebral irradiation, complications, and survival. The key factors for successful outcome seem to be early diagnosis and vigorous therapy.
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PMID:Cerebral metastatic choriocarcinoma: intensive therapy and prognosis. 624 7

Choriocarcinoma responds well to chemotherapy, and its growth can be monitored by measuring human chorionic gonadotropin (HCG) as a tumor marker. Thoracotomy was carried out in six patients with the disease because their pulmonary nodules persisted after repeated courses of chemotherapy over a 4 month period. They were followed up for a long period. These observations suggest that the most important role of thoracotomy is for diagnostic purposes; it is used for therapeutic purposes only when the pulmonary lesion is the only remaining source of increased HCG excretion. Much attention must be paid to tertiary hematogeneous metastases caused by resection of pulmonary foci that are unresponsive to chemotherapy.
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PMID:Role of thoracotomy in pulmonary metastases from gestational choriocarcinoma. 668 18

Choriocarcinoma most commonly occurs within the uterine corpus. Just as placental implantation rarely occurs in the cervix, choriocarcinoma of the cervix is unusual. A case is presented of a 35-year old white woman, para 1-0-0-1 who had an uneventful term pregnancy 1 year prior to admission. She used an IUD and reported regular menses until 3 months prior to admission when she noted irregular bleeding. At initial examination a serum pregnancy test was positive, indicating a mass thought to be a cervical leiomyoma and bilateral cystic ovaries. Pathologic interpretation of an endocervical curettage was choriocarcinoma. At that point a hysterectomy was performed; there were no further complications and the patient subsequently received 3 additional courses of methotrexate. Cervical choriocarcionoma may develop from cervical metastases from a primary tumor in the corpus which later spontaneously regresses, malignant transformation of a cervical pregnancy, or transport of chorionic cells from a preceding pregnancy that undergo malignant transformations after a dormant period. In the nulliparous patient the conservation of reproductive function should be considered if possible.
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PMID:Cervical choriocarcinoma associated with an intrauterine contraceptive device: a case report. 668 83

Choriocarcinoma of the bladder was diagnosed in a 54-year-old woman presenting with macroscopic hematuria 17 years following evacuation of a molar pregnancy. The patient was treated by cystoscopic transurethral tumor resection followed by three courses of triple-agent chemotherapy and total abdominal hysterectomy with bilateral salpingo-oophorectomy. Six months later a gradual rise in beta-human chorionic gonadotropin levels led to the diagnosis of recurrent bladder tumor at the site of the previous tumor. The patient underwent a conservative partial cystectomy, and 12 months postoperatively there was no evidence of disease. It is unclear whether the patient developed a primary urinary bladder choriocarcinoma or late metastatic disease from the previous molar pregnancy.
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PMID:Choriocarcinoma of the bladder. Report of a case of primary tumor or late metastasis of a molar pregnancy. 765 Jun 66

Choriocarcinoma is a malignant neoplasm with it's origin in trophoblast. It can be found after every pregnancy, but specially after pregnancy complicated by mola hydatidosa (complication in 2-3% of all molas). The main biochemical marker, used in treatment and prognosis is hCG. There are different prognostic systems for choriocarcinoma: presence of metastases, level of hCG in urine and plasma, end of last pregnancy. Surgical and chemical treatment in used. Outcome is generally good and very good.
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PMID:[Choriocarcinoma]. 877 12

Choriocarcinoma is a rare neoplasm which often spreads extensively. The metastases sometimes appear in the abdominal cavity where they can cause dramatic symptoms. We here describe a patient who had received a cesarean section twelve days before and intraperitoneal hemorrhage was diagnosed when she visited Chang Gung Memorial Hospital's emergency department. At laparotomy, ruptured spleen with active bleeding was found and splenectomy was performed. The histopathologic study revealed a metastatic choriocarcinoma. Multiagent chemotherapy was administrated and the patient responded well. To our knowledge, this is the fourth reported case that metastatic choriocarcinoma resulted in spleen rupture presenting as the principal sign of acute hemoperitoneum. Metastatic choriocarcinoma with rupture should be considered a cause of intraperitoneal hemorrhage in women of child-bearing age.
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PMID:Metastatic choriocarcinoma with spontaneous splenic rupture following term pregnancy: a case report. 882 60

Choriocarcinoma most commonly follows a molar pregnancy, but it may develop after any gestational event. If choriocarcinoma follows a term pregnancy, it is associated with an unfavorable outcome and a 60% survival rate. A 33 year female who had delivered a normal girl 4 months before, presented with a nodule on the scalp behind the right ear. The pathologic diagnosis was compatible with metastatic choriocarcinoma. This tumor did not respond to chemotherapy, and she died a year later of multiple liver and pulmonary metastases. The development of a choriocarcinoma following a full term pregnancy is associated with a poor prognosis. We suggest that patients who do not achieve a clinical or serological remission after EMA-CO treatment be considered for high dose chemotherapy such as transplant.
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PMID:Unusual presentation of a metastatic choriocarcinoma following a full term pregnancy: a case report. 885 2

Choriocarcinoma usually occurs following molar pregnancy and is uncommon following normal pregnancy. This report describes a case of choriocarcinoma in a Congolese woman 2 months after normal full-term birth of her first child. Diagnosis was suspected based on ultrasonographic findings and massive elevation of plasma beta HCG and confirmed by histologic study of placental specimens. The disease progressed rapidly despite chemotherapy and death occurred 7 months after confirmed diagnosis with multiple metastases. The incidence of choriocarcinoma after normal pregnancy is estimated to be only 0.18 cases per 1000 pregnancies in Black Africa. This low incidence increases the likelihood of late diagnosis and increases the severity of prognosis. The poor availability of antitumor drugs is a major handicap for management of these patients in developing countries. Under these conditions, the authors recommend immediate hysterectomy if metastasis has not occurred.
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PMID:[Choriocarcinoma after a normal pregnancy. A case report observed in Brazzaville]. 892 80


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