Liu Ping, Liu Wei, Feng Yuhua, Xiao Xiangyu, Zhong Meizuo
Department of Oncology, Xiang Ya Hospital, Central South University, China.
Medicine (Baltimore). 2019 Jan;98(3):e14020. doi: 10.1097/MD.0000000000014020.
Epithelial ovarian carcinoma (EOC) is the most common type of ovarian carcinoma, and the leading cause of female genital tract cancer-related deaths. However, brain metastasis (BM) of EOC is rare, with an incidence of only 1% to 2%. Ovarian clear cell carcinoma (OCCC), accounting for 5% to 25% of all EOC cases, has a poor prognosis compared with other epithelial cell type carcinomas.
We retrospectively analyzed the clinical data of a 62-year-old female, who was hospitalized with the main complaint of BM detection for 1 month. She was first diagnosed with ovarian cancer in 2004, and underwent a left oophorectomy. Three years later, the cancer metastasized to the other side, and she underwent a right oophorectomy, followed by 7 courses of platinum-based chemotherapy. She received regular follow-up, and tumor markers and pelvic imaging did not show any signs of progression until July 2012.
Combining the clinical manifestations with the results of radiological and pathological examinations, the findings were consistent with a diagnosis of BM from OCCC.
She received more than 20 courses of chemotherapy since July 2012. The BM was detected in 2016, and she underwent an intracranial lesion resection.
Unfortunately, the patient went into a coma after the surgery, and passed away 1 month later.
For early detection of BM in long-term ovarian cancer, emphasis should be placed on the patient's neurological symptoms and signs as well as serum tumor marker changes. The combination of surgery, radiology, and chemotherapy may achieve long overall survival.
上皮性卵巢癌（EOC）是卵巢癌最常见的类型，也是女性生殖道癌症相关死亡的主要原因。然而，EOC的脑转移（BM）很少见，发病率仅为1%至2%。卵巢透明细胞癌（OCCC）占所有EOC病例的5%至25%，与其他上皮细胞类型的癌相比，预后较差。
我们回顾性分析了一名62岁女性的临床资料，她因检测出BM住院1个月。她于2004年首次被诊断为卵巢癌，并接受了左侧卵巢切除术。三年后，癌症转移至另一侧，她接受了右侧卵巢切除术，随后进行了7个疗程的铂类化疗。她接受了定期随访，直到2012年7月肿瘤标志物和盆腔影像学检查均未显示任何进展迹象。
结合临床表现以及放射学和病理学检查结果，诊断结果与OCCC脑转移相符。
自2012年7月起，她接受了20多个疗程的化疗。2016年检测出BM，她接受了颅内病变切除术。
不幸的是，患者术后昏迷，1个月后去世。
对于长期卵巢癌患者脑转移的早期检测，应重视患者的神经症状和体征以及血清肿瘤标志物的变化。手术、放射学和化疗相结合可能实现较长的总生存期。
