Jacobson R J, Morley J E, Shires R, Boles D, Saffer D
S Afr Med J. 1976 Jan 31;50(5):131-4.
Cerebral deposits of choriocarcinoma tend to be multiple and usually result in a rapidly fatal course. Two patients presented with Jacksonian epilepsy due to metastatic choriocarcinoma in the brain. In the first patient, the diagnosis of metastatic choriocarcinoma was unsuspected, since curetted uterine material was normal, the haemagglutination inhibition test for pregnancy was negative and a chest radiograph was unremarkable. A diagnosis of choriocarcinoma was made by brain biopsy 2 days before death. The second patient had been previously treated with systemic chemotherapy (methotrexate and actinomycin D) for uterine and pulmonary choriocarcinoma associated with hyperthyroidism. Human chorionic gonadotrophin could not be detected in the urine when the patient presented with Jacksonian epilepsy. A brain scan showed multiple areas of increased uptake consistent with metastatic choriocarcinoma. She was treated with both systemic chemotherapy and intrathecal methotrexate and cranial irradiation. A complete remission was obtained. Intrathecal methotrexate and cranial irradiation appear to offer a hopeful new approach to the problem of metastatic cerebral choriocarcinoma.
绒毛膜癌的脑转移瘤往往是多发的，通常会导致迅速致命的病程。两名患者因脑转移性绒毛膜癌出现杰克逊癫痫发作。首例患者，由于刮宫所得子宫组织正常、妊娠血凝抑制试验阴性且胸部X光片无异常，最初未怀疑有转移性绒毛膜癌。在死亡前两天通过脑活检确诊为绒毛膜癌。第二例患者曾因伴有甲状腺功能亢进的子宫和肺绒毛膜癌接受过全身化疗（甲氨蝶呤和放线菌素D）。当该患者出现杰克逊癫痫发作时，尿液中未检测到人绒毛膜促性腺激素。脑部扫描显示多个摄取增加区域，符合转移性绒毛膜癌。她接受了全身化疗、鞘内注射甲氨蝶呤和脑部放疗。获得了完全缓解。鞘内注射甲氨蝶呤和脑部放疗似乎为脑转移性绒毛膜癌问题提供了一种有希望的新方法。
