Introduction: Choriocarcinoma is a rare gestational trophoblastic neoplasm with a high risk of pulmonary, hepatic, and, rarely, cerebral metastasis. We report a rare case of intracerebral haemorrhage as an initial manifestation of metastatic choriocarcinoma.
Case presentation: A 33-year-old female with a history of multiple abortions, ectopic pregnancy, and complete hydatidiform mole presented with a disturbed level of consciousness. Emergency brain computed tomography (CT) scan revealed an intraventricular haemorrhage (IVH) and a left frontoparietal, non-traumatic intracerebral haemorrhage (ICH) with a significant midline shift. The patient underwent emergency evacuation of the hematoma and histological evaluation revealed choriocarcinoma. Later investigations revealed evidence of systemic metastasis. The patient underwent chemoradiotherapy and recovered well.
Conclusion: Metastatic choriocarcinoma should always be in the differential of non-traumatic intracerebral haemorrhage in a female child-bearing age. Also, the pathological diagnosis should always be performed in cases of ICH of an unknown source.