Abstract
We describe a patient with neoplastic aneurysms which developed in areas of pancreatic choriocarcinoma during chemotherapy. A 43-year-old female presented with irregular metrorrhagia. CT scan demonstrated a 2.5cm mass in the head of the pancreas and multiple lesion in the lung, liver, adrenal gland and lumber vertebra. The pancreatic tumor enhanced peripherally in the arterial phase and enhanced similar to the surrounding parenchyma of the pancreas in the delayed phase. We performed a lumber vertebra biopsy and diagnosed multiple organ metastases from choriocarcinoma, histologically.
EMA/CO chemotherapy was used to treat this patient for advanced choriocarcinoma. Neoplastic aneurysms developed in the pancreatic lesion of the choriocarcinoma while receiving chemotherapy. Preventive coil embolization was performed on the pancreatic aneurysms. After preventive coil embolization, EMA/CO chemotherapy was continued. Consequently, the EMA/CO chemotherapy was effective and complete remission was obtained.
Pancreatic lesions of choriocarcinoma are extremely rare, however choriocarcinoma result in neoplastic aneurysm formation in the primary and metastatic lesions.
It is necessary to observe the clinical course of pancreatic choriocarcinoma carefully whether strongly stained areas in the tumor progress to neoplastic aneurysms. Chemotherapy should be given to patients with choriocarcinoma while considering the treatment for the aneurysm.
