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

• Main Authors: Giuseppe Emmanuele Umana, Nicola Alberio, Paolo Amico, Anna Maria Lavecchia, Saverio Fagone, Marco Fricia, Giovanni Nicoletti, Salvatore Cicero, Gianluca Scalia
• Format: Article
• Language: English
• Published: Elsevier 2020-06-01
• Series: Interdisciplinary Neurosurgery
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214751920300293

Background: 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. Case description: 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. Conclusions: 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. Keywords: Brain metastasis, Ovarian carcinoma, Cystic, Giant