Metastatic Brain Choriocarcinoma in a Postmenopausal Woman: A Case Report

Patient: Female, 66-year-old Final Diagnosis: Choriocarcinoma Symptoms: Vaginal bleeding Medication: — Clinical Procedure: — Specialty: Obstetrics and Gynecology OBJECTIVE: Unusual clinical course 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 chorio-carcinoma 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.