Effect of Methotrexate Therapy upon Choriocarcinoma and Chorioadenoma

1) Two patients with choriocarcinoma and one with chorioadenoma destruens with proven progressive metastases were treated with methotrexate, a folic acid antagonist, according to intensive regimen of repeated courses of dosages producing substantial but reversible toxicity. Initially high urinary gonadotropin present in all 3 cases approached normal levels following this regimen and such low levels were sustained following cessation of treatment. 2) Unequivocal clinical improvement and radiological evidence of regression of pulmonary metastases was observed in all 3 cases. Nevertheless, extreme variations in pattern of clinical behavior of this type of tumor necessitate more observations before any definitive therapeutic implications may be drawn from these studies.