Subarachnoid hemorrhage in a postpartum mother: A rare manifestation of an uncommon disease

Oraianthi Fiste; Evaggelos Mavrothalassitis; Christos Markellos; Alexandros Rodolakis; Flora Zagouri; Meletios-Athanasios Dimopoulos; Michalis Liontos

doi:10.1016/j.gore.2022.101092

Subarachnoid hemorrhage in a postpartum mother: A rare manifestation of an uncommon disease

Gynecol Oncol Rep. 2022 Oct 25:44:101092. doi: 10.1016/j.gore.2022.101092. eCollection 2022 Dec.

Authors

Oraianthi Fiste¹, Evaggelos Mavrothalassitis¹, Christos Markellos¹, Alexandros Rodolakis², Flora Zagouri¹, Meletios-Athanasios Dimopoulos¹, Michalis Liontos¹

Affiliations

¹ Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
² Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Abstract

Subarachnoid hemorrhage, a potentially lethal medical emergency, represents an atypical clinical manifestation of gestational choriocarcinoma. We present the uncommon case of a 31-year-old primigravid female who presented with cerebral oncotic aneurysmal rupture, five weeks after vaginal delivery. Albeit the absence of neurological deficits after endovascular embolization, the patient was soon readmitted, complaining of fever, abdominal pain, and fetid lochia, all suggestive of puerperal endometritis. Upon a comprehensive diagnostic work-up, she was subsequently diagnosed with metastatic choriocarcinoma. Early initiation of multiagent chemotherapy, despite being in septic shock associated with Escherichia coli bacteremia, resulted in favorable prognosis.

Keywords: Aneurysm; Choriocarcinoma; Gestational trophoblastic disease; Rare gynecological cancers; Subarachnoid hemorrhage.

Publication types

Case Reports