Term delivery choriocarcinoma patient with brain and lung metastases successfully treated by etoposide, methotrexate, actomycin D, cyclophosphamide and vincristine (EMA-CO) chemotherapy

Yuji Hiramatsu, Hisashi Masuyama, Makoto Ishida, Kazuharu Murakami, Masaru Sakurai

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10 Citations (Scopus)


It is well known that antecedent term delivery and metastasis to sites other than the lungs and vagina are high risk factors for patients with gestational trophoblastic neoplasia. Here we report on a patient with choriocarcinoma who presented with brain and lung metastases after term delivery and was treated by EMA-CO chemotherapy. A 31-year-old woman delivered a healthy infant at term. Frequent episodes of hemoptysis occurred beginning 3 weeks after the delivery. On admission to our hospital, she had lesions in the uterus, lungs and brain as well as motor aphasia and hemiplagia. The pretreatment β-hCG level was 21,000 ng/ml and the WHO score was 16 (high-risk group). The EMA-CO regimen was administrated as first-line chemotherapy and the patient achieved complete remission after 7 courses. Treatment was terminated after 11 courses and maintained with etoposide (25 mg/day) for 6 months. The patient has remained in complete remission for more than 16 years without other adjuvant therapies. We believe that EMA-CO can currently be considered the regimen of first choice for most high-risk patients with gestational trophoblastic neoplasia in view of its effectiveness and excellent tolerability. Copyright

Original languageEnglish
Pages (from-to)235-238
Number of pages4
JournalActa medica Okayama
Issue number5
Publication statusPublished - Oct 1 2005



  • Choriocarcinoma
  • EMA-CO chemotherapy
  • Metastasis
  • Term delivery

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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