Intracerebral Haemorrhage with Choriocarcinoma in a Teenager - A Case Report

Intracerebral haemorrhage is one of the uncommon initial CNS manifestations of choriocarcinoma in reproductive age group women. Disease is usually diagnosed by history, clinical examinations and investigations like CT scan of brain and chest, MRI of brain, USG, X-ray chest P/A view and high level of a-hCG in serum and CSF. Overall prognosis of this disease is generally good (80-90% long term survival with chemotherapy and radiotherapy). But intracranial metastasis has poor prognosis which comprises 3-28% of choriocarcinoma. Most intracranial metastasis occurs late in the course of disease but 20% experiences as first sign. Our patient is a teenager girl presented with convulsion and loss of consciousness. CT scan of brain revealed hemorrhage in right fronto-parietal region with ventricular extension, X-ray chest P/A view shows metastasis in mid zone of right lung, USG shows invasion in posterior myometrium and high concentration of serum a-hCG (273400 mUI/ ml) confirmed our diagnosis. This case report describes that the conservative treatment with radiotherapy and chemotherapy gives good outcome of with metastasic intracerebral haemorrhage with choriocarcinoma is rewarding with farther radio and chemotherapy