Introduction Choriocarcinoma is a rare form of gestational trophoblastic neoplasia, which occurs in approximately 1 in 20,000-40,000 pregnancies. About half of choriocarcinomas occur after molar pregnancies, rest can occur after a spontaneous abortion, ectopic pregnancy, or a term pregnancy.1Choriocarcinoma arises from villous trophoblast and placental-site trophoblastic tumors from the interstitial trophoblast. In addition to the uterus, choriocarcinoma may also develop in the fallopian tubes, liver, lungs, spleen, kidneys, colon, and brain.1It is characterized by a propensity to metastasize rapidly to various distant sites, particularly the lungs (94%), vagina (44%), and liver (28%). Intracranial metastases from choriocarcinoma are uncommon and cerebral intratumoral haemorrhage resulting from metastatic choriocarcinoma is an even rarer entity, especially in the young.2, 3, 4 Structural lesions such as arteriovenous malformations and aneurysms are typically the cause of lobar intracerebral hemorrhage (ICH), whereas hypertension is typically the cause of non-lobar ICH in young people.5Even though choriocarcinoma is highly aggressive, it is very responsive to chemotherapy.1, 6 Therefore, the importance of early detection cannot be over-emphasized.3 We present three cases of choriocarcinoma with brain metastases who presented with intracranial hemorrhage. The case series is to draw attention to metastatic choriocarcinoma as a cause of unexplained intracerebral hemorrhage in women of childbearing age.
