[A case of primary intracranial choriocarcinoma with a carotid-cavernous fistula].

A 14-year-old Japanese girl was admitted to Kosei General Hospital on May 28, 1987 because of disturbance of visual acuity, bitemporal hemianopsia and general fatigue. About two months before, she had noticed disturbance of visual acuity and headache. The CT scans demonstrated iso density mass in the chiasmatic region with ring enhancement. Bilateral carotid angiograms showed bilateral carotid-cavernous fistulas. The serum HCG rose to 13000 IU/ml (HCG-beta, 480 ng/ml) whereas the urinary level was 2200 mIU/ml and alpha-feto protein was normal. A diagnosis of choriocarcinoma was made. Radiation therapy and combined chemotherapy (cisplatinum, vinblastine, bleomycin) were begun. But radiation and chemotherapy had little effect. On June 12, 1987, chest X-ray film showed several abnormal shadows in both lungs, and her general condition continued to deteriorate. She died on June 21, 1987. Histologic examination of the tumor disclosed cytotrophoblastic cells and syncytiotrophoblastic cells with extensive hemorrhage and necrosis. Extracranial metastasis was found only in both lungs.