Takahara Kento, Katayama Makoto, Tamura Ryota
Department of Neurosurgery, Kawasaki Municipal Hospital, Kawasaki 210-0013, Japan.
Department of Neurosurgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
Brain Sci. 2022 Jun 7;12(6):748. doi: 10.3390/brainsci12060748.
Leptomeningeal carcinomatosis (LMC) is a rare but devastating complication of advanced cancer. Breast cancer, lung cancer, and melanoma are the three most common causes of LMC, whereas it is rare in ovarian cancer. Here, we report the case of a 59-year-old woman who was diagnosed with LMC from ovarian cancer and was successfully treated with intrathecal chemotherapy via Ommaya reservoir and radiation therapy. The patient had an amelioration of symptoms and prolonged survival. Though LMC from ovarian cancer is thought to be rare, it is not going to remain a rare entity because the incidence of LMC in general is thought to be increasing, which is also the case with ovarian cancer. According to 31 cases whose treatment course is reported in literature, despite the absence of an established treatment for LMC, intrathecal (IT) chemotherapy whose survival benefit has been suggested in past studies might also prolong survival in patients with LMC from ovarian cancer. IT chemotherapy via Ommaya reservoir may be preferred to the lumbar puncture route. The presentation of non-specific symptoms of LMC in patients may hinder its diagnosis; however, early diagnosis and treatment induction is the key for patients' prolonged survival and restored useful life.
软脑膜癌病(LMC)是晚期癌症一种罕见但极具破坏性的并发症。乳腺癌、肺癌和黑色素瘤是LMC最常见的三种病因,而在卵巢癌中则较为罕见。在此,我们报告一例59岁女性患者,她被诊断为卵巢癌所致的LMC,并通过Ommaya储液器进行鞘内化疗及放射治疗后获得成功治疗。患者症状得到改善,生存期延长。尽管卵巢癌所致的LMC被认为罕见,但由于总体上LMC的发病率被认为在上升,卵巢癌也是如此,所以它不会一直是罕见病例。根据文献报道的31例治疗过程,尽管尚无针对LMC的确立治疗方法,但过去研究提示有生存获益的鞘内(IT)化疗可能也会延长卵巢癌所致LMC患者的生存期。通过Ommaya储液器进行IT化疗可能比腰椎穿刺途径更可取。LMC患者出现非特异性症状可能会妨碍其诊断;然而,早期诊断和开始治疗是患者延长生存期及恢复有意义生活的关键。