Kodama Michiko, Kawaguchi Haruna, Komoto Yoshiko, Takemura Masahiko
Department of Gynecology and Obstetrics, Osaka General Medical Center, Osaka, Japan.
J Obstet Gynaecol Res. 2010 Feb;36(1):199-203. doi: 10.1111/j.1447-0756.2009.01102.x.
Involvement of intramedullary spinal cord and the choroid by ovarian cancer is rare, and coexistence of metastases at these sites is extremely rare and has never been reported. This condition rapidly progresses to a neurological emergency; however, an efficient standard treatment method is not available for this rare condition. The case presented herein is of a female patient with stage II, poorly differentiated serous cystadenocarcinoma of the ovary. She presented with blindness and other neurologic complaints during the course of treatment for a recurrence at 50 months after the primary surgical treatment for the tumor. Magnetic resonance imaging (MRI) revealed intramedullary spinal cord metastasis and choroidal metastasis, coexisting with multiple brain metastases and intra-abdominal lesions. Neurological emergency was prevented by administering whole-brain irradiation therapy followed by systemic chemotherapy. Early diagnosis and multidisciplinary treatment, including radiotherapy and chemotherapy, may offer good palliation for such unusual metastases of ovarian cancer.
卵巢癌累及脊髓髓内和脉络膜的情况罕见,而这些部位同时发生转移极为罕见,此前从未有过报道。这种情况会迅速发展为神经急症;然而,对于这种罕见病症,目前尚无有效的标准治疗方法。本文介绍的病例是一名患有卵巢II期低分化浆液性囊腺癌的女性患者。在肿瘤初次手术治疗50个月后复发的治疗过程中,她出现了失明及其他神经症状。磁共振成像(MRI)显示存在脊髓髓内转移和脉络膜转移,同时伴有多发脑转移和腹腔内病变。通过先行全脑放疗,随后进行全身化疗,预防了神经急症的发生。早期诊断以及包括放疗和化疗在内的多学科治疗,可能会为卵巢癌这种不寻常的转移提供良好的姑息治疗效果。