CT evaluation of choriocarcinoma with brain metastases

ABSTRACT

It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.