J Korean Neurosurg Soc.  2010 Feb;47(2):143-147. 10.3340/jkns.2010.47.2.143.

Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

• Lee JH
• Park CW
• Chung DH
• Kim WK

• KMID: 1453147
• DOI: http://doi.org/10.3340/jkns.2010.47.2.143

Abstract

We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

Keyword

Metastatic choriocarconoma; Spinal metastasis

MeSH Terms

Adult
Arteriovenous Malformations
Back Pain
Biopsy
Brain
Cesarean Section
Choriocarcinoma
Dyspnea
Edema
Female
Fetal Death
Headache
Hemangioma
Hemoptysis
Hemorrhage
Humans
Laminectomy
Lung
Neoplasm Metastasis
Paraparesis
Parietal Lobe
Polymethyl Methacrylate
Pregnancy
Spine
Polymethyl Methacrylate