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Primary non-gestational mediastinal choriocarcinoma metastatic to the brainstem
  1. Orlando De Jesus1,
  2. Joel E Pellot Cestero1,
  3. Frances M Gómez-González2 and
  4. Román Vélez2
  1. 1Neurosurgery, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
  2. 2Pathology and Laboratory Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
  1. Correspondence to Dr Orlando De Jesus; drodejesus{at}


Choriocarcinoma is a highly malignant tumour emerging from the syncytiotrophoblast divided into gestational and non-gestational presentations. Primary choriocarcinoma of the mediastinum is rare. Metastases to the brain often occur; however, brainstem involvement has not been reported for non-gestational choriocarcinoma. We described a middle-aged man who developed a complete left oculomotor nerve paralysis secondary to a brainstem tumour at the midbrain. The workup for the primary source of the brainstem tumour included a chest CT scan, which revealed a mediastinal mass. A mediastinal mass needle biopsy confirmed the diagnosis of primary mediastinal choriocarcinoma. Despite aggressive chemotherapy, the patient died 6 months after the initial presentation from neurological complications and multiorgan failure.

  • Neurosurgery
  • Pathology
  • Neurooncology
  • Neuroimaging
  • Brain stem / cerebellum

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  • Contributors Concept: ODJ, JEPC. Drafting the article: ODJ, JEPC. Revising final manuscript: ODJ, JEPC, FMGG, RV. Approval of final manuscript: ODJ, JEPC, FMGG, RV.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.