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Metastatic Brain Choriocarcinoma in a Postmenopausal Woman: A Case Report

Inessa Dombrovsky, Hannah R. Tilden, Tania Aftandilians, Shirley Wong, Robert J. Stowe

(Department of Women’s Health, Arrowhead Regional Medical Center, Colton, CA, USA)

Am J Case Rep 2020; 21:e917656

DOI: 10.12659/AJCR.917656

BACKGROUND: Choriocarcinoma is the most aggressive form of gestational trophoblastic disease and usually occurs in women of childbearing age, most commonly within 1 year after an abnormal pregnancy. Postmenopausal choriocarcinoma is exceptionally rare and few cases have been described in the literature.
CASE REPORT: We present the case of a 66-year-old woman who presented to the Emergency Department with sudden onset of left upper- and lower-extremity weakness. She was found to have a brain mass, which was excised by neurosurgery and found to be a choriocarcinoma. She was then started on standard first-line therapy of EMACO, but was subsequently lost to follow-up.
CONCLUSIONS: Postmenopausal choriocarcinoma is rare and there are few case reports in the literature. It is a rare but possibly under-diagnosed metastatic disease in women. At present, a postmenopausal woman without a clear primary tumor should have a pregnancy test performed to rule out choriocarcinoma, as it is readily responsive to therapy.

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