METASTATIC CHORIOCARCINOMA - CORRELATION OF MRI, CT, AND ANGIOGRAPHY

CHORIOCARCINOMA is uncommon in the US, occurring in 1/24,096 pregnancies.(1,2) It is a neoplasm of syncytiotrophoblastic origin that occurs approximately 50% of the time after a molar pregnancy and less frequently after a normal pregnancy (25%) or spontaneous abortion (24%).(2) The lung and vagina are the most frequent sites of metastatic disease, though metastasis has been reported in the brain and the genito-urinary and gastrointestinal systems.(3,4) When choriocarcinoma is suspected, rising blood titers of the beta-subunit of human chorionic gonadotropin (beta-HCG) are diagnostic. When the tumor is unsuspected, however, its presentation and appearance on imaging studies present a diagnostic challenge. We report a case of unsuspected choriocarcinoma metastatic to the liver, GI tract, and eventually the brain in a patient who had no recent history of pregnancy.