脑转移性GTN未经放疗：1例报告

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-07-21 DOI:10.1016/j.gore.2025.101813

Soheila Aminimoghaddam, Maryam Ghoreyshi, Alireza Zakaryaei, Elahe Ghaderi

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引用次数: 0

摘要

绒毛膜癌是一种罕见的、侵袭性的妊娠滋养细胞瘤（GTN），在晚期可能转移到大脑。脑部受累通常表现为脑出血，并伴有高发病率和死亡率。虽然全脑放疗（WBRT）仍然是化疗的标准辅助手段，但它具有显著的长期神经认知风险。我们报告一位28岁的女性，因绒毛膜癌的出血性脑转移而出现神经系统症状。急诊开颅以排出血肿并切除肿瘤。组织病理学证实为转移性绒毛膜癌。患者接受了全身多药化疗，采用EMA-CO和EMA-EP方案，未使用WBRT或鞘内化疗。血清hCG水平恢复正常，随访影像显示无复发，表明完全缓解。结论：该病例强调了采用紧急神经外科干预和全身化疗相结合的治疗策略，脑转移性绒毛膜癌有完全缓解的潜力。避免WBRT可以减少选定患者的长期认知并发症。在高风险GTN的管理中，多学科方法仍然至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Brain metastatic GTN treated without radiotherapy: Case report

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Brain metastatic GTN treated without radiotherapy: Case report

Background

Choriocarcinoma is a rare, aggressive form of gestational trophoblastic neoplasia (GTN) that may metastasize to the brain in advanced stages. Brain involvement typically manifests as intracerebral hemorrhage and is associated with high morbidity and mortality. While whole brain radiotherapy (WBRT) remains a standard adjunct to chemotherapy, it carries significant long-term neurocognitive risks.

Case presentation

We report the case of a 28-year-old female who presented with neurological symptoms caused by a hemorrhagic brain metastasis from choriocarcinoma. Emergency craniotomy was performed to evacuate the hematoma and resect the tumor. Histopathology confirmed metastatic choriocarcinoma. The patient received systemic multi-agent chemotherapy using EMA-CO and EMA-EP regimens, without WBRT or intrathecal chemotherapy. Serum hCG levels normalized, and follow-up imaging showed no recurrence, indicating complete remission.

Conclusion

This case highlights the potential for complete remission in brain metastatic choriocarcinoma using a treatment strategy that combines emergency neurosurgical intervention and systemic chemotherapy alone. Avoiding WBRT may reduce long-term cognitive complications in selected patients. A multidisciplinary approach remains essential in the management of high-risk GTN.

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.