Synchronous skull base and spinal metastases in a patient with treatment-resistant, high-grade serous adenocarcinoma of tubo-ovarian origin

BMJ Case Rep. 2024 May 21;17(5):e259144. doi: 10.1136/bcr-2023-259144.

Abstract

Brain metastases (BMs) arising from ovarian cancer remain rare. Spinal cord metastases are even rarer, accounting for just 0.4% of total metastatic spinal cord compressions. In this report, we describe a case of a woman in her 70s who developed sequential brain and spinal cord metastases during her treatment for high-grade serous ovarian cancer, without a germline or somatic BRCA mutation. Following completion of neoadjuvant chemotherapy, interval debulking surgery and adjuvant chemotherapy, relapsed disease was ultimately identified as a single BM, curiously mimicking an acoustic neuroma. Subsequently, spinal cord metastases rapidly developed. Throughout, multidisciplinary team meetings guided decisions on patient management. In this report, we highlight the rarity of such a presentation and discuss the possible role of disease pathophysiology, associated systemic anticancer therapy resistance, and treatment possibilities for both cerebral and spinal metastases.

Keywords: Gynecological cancer; Neurooncology; Spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cystadenocarcinoma, Serous / drug therapy
  • Cystadenocarcinoma, Serous / secondary
  • Cystadenocarcinoma, Serous / therapy
  • Female
  • Humans
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / secondary
  • Ovarian Neoplasms* / therapy
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / secondary
  • Skull Base Neoplasms / therapy
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / secondary
  • Spinal Cord Neoplasms / therapy