Introduction/Background Ultra high risk gestational trophoblastic neoplasia with brain metastasis have high mortality due to early death during chemotherapy. The recommended treatment is a therapy induction with cisplatin and etoposid followed by systemic polychemotherapy with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA/CO) with intrathecal methothrexat application. In our reported case complications prohibited standard treatment.

Methodology Case report.

Results A 26-year-old patient, after being initially treated with methotrexate for suspected extrauterine pregnancy, presented at our hospital with gestational choriocarcinoma with pulmonary, brain and intraabdominal metastases. During induction therapy with cisplatin and etoposide the patient had intracerebral hemorrhage. After the implantation of a Rickham-reservoir she developed intracranial parenchymatous lesions which led to the explantation of the reservoir. Due to these events we could not apply EMA/CO chemotherapy. Since etoposid has a good brain penetration we chose to continue the etoposide cisplatin regimen. After six cycles she had complete remission according to human gonadotropin levels and imaging studies. We continued up to eleven cycles. The patient is now in complete remission with a follow-up of six months.

Conclusion In the case presented we successfully applied etoposide cisplatin treatment in a patient with CCA with brain metastasis, when standard chemotherapy regimen could not be given due to complications.

Disclosure Nothing to disclose