Multiple intracerebral hemorrhage as first presentation of metastatic choriocarcinoma: A case report

Metastatic brain tumors are the rare cause of intracerebral hemorrhage in the young. In this case, we present a case of a 23-year-old woman presented to emergency department with history of recurrent vomiting,sudden fall and loss of consciousness. she had past history of incomplete abortion 9 month back, history of pain abdomen and irregular vaginal bleeding last 6months.Computed tomography head showed multiple intracerebral hemorrhagewith midline shift. Chest X ray show multiple nodular opacity in bilateral lungs. CECT abdomen and pelvis revealed of heterogenous enhancing soft tissue density mass in pelvic cavity with non-separate visualization of bilateral adnexa with extension, involvement and deposits suggestive of choriocarcinoma with metastasis to lungs and brain. This patient responded well with combined treatment osmotic diuretics,antiepileptics, antibiotics and combination of chemotherapy and radiotherapy.This is a rare phenomenon of intracerebral hemorrhages secondaries to brain from choriocarcinoma. The better knowledge of this entity would facilitate earlier diagnosis and improve the outcome.