抄録
Primary intracranial choriocarcinoma is relatively rare, and only 56 cases have been reported since the first description by Askanasy et al. Few reports are available concerning the sequential change of the human chorionic gonadotropin (HCG)-β subunit with therapeutic correlations.
The patient, a 17-year-old male, was admitted because of signs and symptoms of increased intracranial pressure, progressive worsening of right hemiparesis and generalized convulsive seizures for four years. Enhanced CT showed a small mass lesion of high density in the genu of the corpus callosum near the interventricular foramen. Hormonal studies showed an excessively high level of HCG-β in the serum, urine, and cerebrospinal fluid. Serum a-fetoprotein and carcinoenzymic antigen were negative. After irradiation, HCG-β decreased to the normal level. Three months later, he abruptly became comatose because of a tumoral hemorrhage extending into the right capsular region. The intracerebral hematoma mixed with the tumor was removed. Histopathologically, the tumor was diagnosed as choriocarcinoma. Immunohistochemical staining revealed localization of HCG in syncytiotrophoblasts. One month postoperatively, the patient remained unresponsive.
Serial evaluation of HCG-β is useful in the follow-up of choriocarcinoma. Early detection and surgical intervention combined with radio-chemotherapy may be effective against this malignant tumor.
