Primary intracranial choriocarcinoma

Abstract

Four cases of primary intracranial choriocarcinoma, all in young human males, are reported. Three tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in 3 cases and precocious puberty in 2 cases. Angiography revealed tumor stain with irregular vessels in all cases. Enhanced computerized tomography scans in the last 2 cases demonstrated a round, lobulated lesion of high density, with relatively low density in the central portion. Hormonal study was carried out in 3 cases. In addition to high levels of human chorionic gonadotropin (HCG) in the urine and CSF and/or of plasma luteinizing hormone (LH), LH in the tumor tissue or medium obtained via cell cultures was high in the 3 cases, suggesting inherent activity of HCG secretion by the tumor cells. The tumors were relatively demarcated from the surrounding brain. They were very hemorrhagic and fresh hematoma was identified in the tumor in 1 case. Good results were obtained in 2 cases treated with surgical removal followed by simultaneous chemotherapy and 60Co irradiation.