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Brain metastases from gestational trophoblastic neoplasia: review of pertinent literature

  • E. Piura1
  • B. Piura2,*,

1Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar-Saba, Sackler School of Medicine, University of Tel-Aviv

2Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva (Israel)

DOI: 10.12892/ejgo26312014 Vol.35,Issue 4,July 2014 pp.359-367

Published: 10 July 2014

*Corresponding Author(s): B. Piura E-mail: XXX


Brain metastasis from gestational trophoblastic neoplasia (GTN) is rare with about 222 cases documented in the literature and an incidence of about 11% in living GTN patients. Brain metastasis from GTN was part of a disseminated disease in 90% of patients, single metastases in the brain – 80% and located in the cerebrum – 90%. Brain metastasis was the only manifestation of metastatic GTN in 11.3% of patients, appeared synchronously with metastatic GTN in other sites of the body – 30.6% and was diagnosed from 0.3 to 60 months after diagnosis of metastatic GTN in other sites (most often in the lung) – 58.1%. Overall, 83.9% of patients with brain metastases from GTN had also lung metastases from GTN. Brain metastases from GTN showed a greater tendency to be hemorrhagic compared to brain metastases from other primaries. In patients with brain metastases from GTN, the best outcome was achieved with multimodal therapy including craniotomy, whole brain radiotherapy, and EP-EMA or EMA-CO chemotherapy. Nonetheless, brain metastasis from GTN is a grave disease with a median survival time from diagnosis of brain metastasis of about 12 months.


Brain; Choriocarcinoma; GTD; GTN; Metastases.

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E. Piura,B. Piura. Brain metastases from gestational trophoblastic neoplasia: review of pertinent literature. European Journal of Gynaecological Oncology. 2014. 35(4);359-367.


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