A Rare Case of Choriocarcinoma 
with Cerebral Metastasis 
Dr. Richa Katiyar 
MBBS, MD (AIIMS) 
Dr. Richa Katiyar, Web: www...
Mrs P, 26 yr, P3+0+1+3, resident of Bihar 
Presenting complaints: 
- Irregular bleeding PV -11 months 
(since last childbi...
Menstrual history 
Previous cycles 4/28 days, normal flow 
Obstetric History 
P3+0+1+3; FTND, alive and healthy, 
LCB - 11...
On examination GPE :- 
- Well oriented to time, place, person 
- GC fair 
- Afebrile 
- PR - 90/min regular 
- BP - 110/70...
Examination (contd.) 
Breasts : NAD 
Thyroid : NAD 
Chest : B/L clear 
CVS : NAD 
CNS : Higher functions normal, NAD 
P/A ...
Examination (contd.) 
P/S : - Cervix and vagina - healthy 
- Mild bleeding from os 
P/V : - Uterus R/V, bulky, soft, mobil...
Investigations 
- Blood group : O+ 
- Hb: 8.2 g/dl 
- TLC : 4800/mm3 
- DLC : P63 L33 E2 M2 
- LFT and KFT : WNL 
- CXR: W...
Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in 
Email: dr.richa.katiyar@gmail.com
Investigations (contd.) 
Ultrasound: 
Upper abdominal viscera : normal 
Uterus bulky, fluid collection in endometrial 
cav...
3 days later, patient presented to Casualty 
Altered sensorium - 2 days 
GTCS - one episode 
Dr. Richa Katiyar, Web: www.h...
On examination 
- Drowsy 
- PR - 78 /min, BP - 130/80 mm Hg 
- Glasgow Coma Scale: E4 V3 M6 
- Pupils – Normal sized, reac...
- Emergency right frontal craniotomy, frontal 
lobectomy and gross total excision of tumor 
under GA. 
HPE : metastatic ch...
Paraplegia recovered within 3 days 
- Patient received 5 sittings of Whole Brain RT 
(total dose 2000 cGy) 
and 4 cycles o...
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Chorio carcinoma in pregnancy- a case report.

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A case report of a pregnant lady with choriocarcinoma.

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Chorio carcinoma in pregnancy- a case report.

  1. 1. A Rare Case of Choriocarcinoma with Cerebral Metastasis Dr. Richa Katiyar MBBS, MD (AIIMS) Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  2. 2. Mrs P, 26 yr, P3+0+1+3, resident of Bihar Presenting complaints: - Irregular bleeding PV -11 months (since last childbirth) - Headache and vomiting - 6 months Referred from Govt. Medical College , Patna with a CT diagnosis of frontal lobe oligodendroglioma. Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  3. 3. Menstrual history Previous cycles 4/28 days, normal flow Obstetric History P3+0+1+3; FTND, alive and healthy, LCB - 11 months ago Past history and family history – NAD Personal history : Low socioeconomic strDar.t Raic,h av Keatgiyaer, tWaebr:i awwnw,.h ohwo-tou-gest-eprwegniafnet.i.n Email: dr.richa.katiyar@gmail.com
  4. 4. On examination GPE :- - Well oriented to time, place, person - GC fair - Afebrile - PR - 90/min regular - BP - 110/70 mm Hg - Pallor – mild - No icterus / cyanosis / clubbing /pedal edema / lymphadenopathy Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  5. 5. Examination (contd.) Breasts : NAD Thyroid : NAD Chest : B/L clear CVS : NAD CNS : Higher functions normal, NAD P/A : Soft, no palpable masses Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  6. 6. Examination (contd.) P/S : - Cervix and vagina - healthy - Mild bleeding from os P/V : - Uterus R/V, bulky, soft, mobile, B/L fornices free, os closed Provisional diagnosis: Choriocarcinoma Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  7. 7. Investigations - Blood group : O+ - Hb: 8.2 g/dl - TLC : 4800/mm3 - DLC : P63 L33 E2 M2 - LFT and KFT : WNL - CXR: WNL Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  8. 8. Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  9. 9. Investigations (contd.) Ultrasound: Upper abdominal viscera : normal Uterus bulky, fluid collection in endometrial cavity. Bilateral adnexa : normal Endometrial Aspirate HPE - Choriocarcinoma Serum Beta HCG – 6000 mIU/ml Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  10. 10. 3 days later, patient presented to Casualty Altered sensorium - 2 days GTCS - one episode Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  11. 11. On examination - Drowsy - PR - 78 /min, BP - 130/80 mm Hg - Glasgow Coma Scale: E4 V3 M6 - Pupils – Normal sized, reacting to light - Bilateral papilloedema + - Left spastic hemiparesis +, power grade 4/5 - Plantars - B/L upgoing - No meningeal signs Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com
  12. 12. - Emergency right frontal craniotomy, frontal lobectomy and gross total excision of tumor under GA. HPE : metastatic choriocarcinoma Final Diagnosis: Choriocarcinoma Stage IVb, WHO Score-12 Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.comSS
  13. 13. Paraplegia recovered within 3 days - Patient received 5 sittings of Whole Brain RT (total dose 2000 cGy) and 4 cycles of multiple-agent chemotherapy (EMACO regimen). Dr. Richa Katiyar, Web: www.how-to-get-pregnant.in Email: dr.richa.katiyar@gmail.com

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