Giant cystic brain metastasis from ovarian papillary serous adenocarcinoma: Case report and review of the literature

• Published in: Interdisciplinary neurosurgery : Advanced techniques and case management Vol. 20; p. 100668
• Main Authors: Umana, Giuseppe Emmanuele, Alberio, Nicola, Amico, Paolo, Maria Lavecchia, Anna, Fagone, Saverio, Fricia, Marco, Nicoletti, Giovanni, Cicero, Salvatore, Scalia, Gianluca
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-06-2020; Elsevier
• Subjects: Brain metastasis; Cystic; Giant; Ovarian carcinoma; Cystic; OS; Ovarian carcinoma; MRI; IONM; AFP; CT; Ca 19.9; Brain metastasis; iCT; Giant; CEA; CEUS
• ISSN: 2214-7519; 2214-7519
• DOI: 10.1016/j.inat.2020.100668

•Brain metastases from primary ovarian cancer are very rare, occurring in 1% of cases.•A metastases size classification does not exist, so we define giant those > 7 cm.•Ovarian cystic brain metastases present a good outcome following radical treatments.
Ovarian brain metastases represent a very rare occurrence and without treatment, prognosis is very poor, with a median survival of one month. We present a unique case of a patient affected by a giant cystic intracerebral metastasis (>7 cm) secondary to an ovarian papillary serous adenocarcinoma, along with a review of the literature regarding large cystic ovarian metastases and their management.
A 49-years-old female patient was admitted to our institution because she presented progressive headache and altered consciousness. Brain computed tomography (CT) scan and magnetic resonance imaging (MRI) revealed the presence of a giant left frontal intracerebral cystic lesion. The patient underwent a surgical removal of an ovarian high-grade papillary serous adenocarcinoma three years before. We performed a left frontal craniotomy and microsurgical removal of the brain lesion, achieving a safe macroscopic total resection, thanks to intraoperative neurophysiological monitoring (IONM). The post-operative period was uneventful with a complete recovery. Post-operative brain MRI showed a complete removal of the lesion.
The presence of a giant cystic metastasis with symptoms of intracranial hypertension needs a radical and safe surgical removal, along with the management of a multidisciplinary oncologic group.