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Metastatic choriocarcinoma
  1. Umesh Vivekananda,
  2. Robin Simon Howard,
  3. Walid Matar,
  4. Rahul Phadke
  1. National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
  1. Correspondence to Dr Robin S Howard, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1 3BG, UK; robin.howard{at}uclh.nhs.uk

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Case report

A man in his late 20s with a 2-month history of stage IV germ-cell testicular tumour and multiple lung and liver metastases, previously treated with chemotherapy, was admitted with a depressed level of consciousness.

CT head scan showed marked cerebral oedema with bilateral sulcal and cisternal effacement. Postcontrast scans showed a high attenuation, enhancing lesion in the right parieto-occipital lobe compatible with a metastasis. MRI scan showed extensive and multiple areas of high signal intensity on axial and coronal T2 and fluid-attenuated inversion recovery sequences. These involved the white matter of the cerebral and cerebellar hemispheres and brainstem. Gradient echo …

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