Primary intracranial choriocarcinoma.

The authors report four cases of primary intracranial choriocarcinoma, all in young males. There tumors occurred in the pineal region and one in the lateral ventricle. Besides the signs of increased intracranial pressure and ophthalmological disorders, skin pigmentation or eruption was observed in three cases and precocious puberty in two cases. Angiography revealed tumor stain with irregular vessels in all cases. Enhanced computerized tomography scans in the last two cases demonstrated a round, lobulated lesion of high density, with relatively low density in the central portion. Hormonal study was carried out in three cases. In addition to high levels of human chorionic gonadotropin (HCG) in the urine and cerebrospinal fluid and/or of plasma luteinizing hormone (LH), LH in tumor tissue or medium obtained via cell cultures was also high in all three cases, suggesting inherent activity of HCG secretion by the tumor cells. The tumors were relatively demarcated from the surrounding brain. They were very hemorrhagic, and fresh hematoma was identified in the tumor in case. Good results were obtained in two cases treated with surgical removal followed by simultaneous chemotherapy and 60Co irradiation.