Early Rebleeding of Multiple Hemorrhagic Metastatic Choriocarcinoma with Intracerebral Hemorrhage

Choriocarcinoma is a rare, highly malignant gestational trophoblastic neoplasia. This tumor is known for its rapid hematogenous spread to multiple organs and good response to chemotherapy. However, cerebral metastases occur frequently, and hemorrhage from cerebral metastases is a common cause of death. Therefore, patients with cerebral metastases require intensive multimodal therapy to achieve remission. Here, we report the case of a 38-year-old woman with multiple hemorrhagic metastases of choriocarcinoma who developed intracerebral hemorrhage, for which she underwent craniotomy and total removal of the hematoma. Five days after surgery, rebleeding of a large intracerebral hemorrhage developed and an emergency reoperation was performed. We suggest that surgeons carefully consider all patient-related data and always pay attention to changes in the neurological state of a patient. Surgeons should also do their best to completely remove the intracerebral choriocarcinoma in the first operation.