Singular brain metastasis from epithelial ovarian carcinoma – a case report

Background Epithelial ovarian carcinoma is the most common type of ovarian carcinoma, and the leading cause of female genital tract cancer-related deaths. However, brain metastasis of epithelial ovarian cancer is rare (1-2 %).

Case A 66-year old patient presented herself with progressive episodes of aphasia for 3 months. She told her doctors that she understands everything and knew what to answer but she could not pronounce her words properly (Broca’s Aphasia). In her medical history she was diagnosed with epithelial ovarian cancer 22 months ago treated with neoadjuvant chemotherapy and surgical resection. A cat scan showed no evidence of systemic recurrence but a parietotemporal tumour on the left side matching her clinical symptoms. The patient was transferred to neurosurgical ward and the tumour was resected completely.

The tumour was classified morphologically and immunohistochemically as a metastasis of the known epithelial ovarian carcinoma. The tumour cells were positive for MNF 116, WT1 and estrogenic receptors. Following surgical resection she received stereotactic radiotherapy. In absence of systemic metastasis we renounced an additional chemotherapy. Four weeks after hospitalisation and radiotherapy she was able to pronounce her words slowly but properly.

Conclusion This is a rare case of a singular brain metastasis without evidence of systemic recurrence. Brain metastasis of ovarian epithelial cancer is reported in fewer than 600 cases in literature. Survival for patients with brain metastasis is generally poor; however, the literature on prognostics, survival, and treatment options for patients with epithelial ovarian cancer offers limited applicability to patients with only one metastasis.

Publication History

Article published online:
07 October 2020