Department of Pathology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Neurosurgery, Health Sciences University Umraniye Training and Research Hospital, Istanbul, Turkey.
Diagn Cytopathol. 2023 Aug;51(8):E228-E231. doi: 10.1002/dc.25145. Epub 2023 Apr 18.
Metastases from ovarian cancer to the central nervous system (CNS) are rare, in particular, isolated leptomeningeal metastases (LM) are extremely rare. The gold standard in the diagnosis of leptomeningeal carcinomatosis (LC) is the detection of malignant cells in cerebrospinal fluid (CSF) cytology. A 58-year-old woman diagnosed with ovarian cancer 2 years ago underwent lumbar puncture and CSF cytology in recent months due to new weakness, loss of strength in the lower extremities, and speech disorders. Magnetic resonance imaging CNS was simultaneously visualized and linear leptomeningeal enhancement was demonstrated. CSF cytology showed tumor cells as isolated cells or small clusters of tumor cells with large, partially vacuolated, and abundant cytoplasm, mostly with centrally located nuclei. Given her history of high-grade clear cell ovarian cancer,CSF cytology was positive for malignant cells and a diagnosis of leptomeningeal carcinomatosis was made by the neuro-oncology multidisciplinary tumor board. Since LM also implies a systemic disease, the prognosis is very poor, CSF cytology will play an important role in rapid diagnosis and will be useful both in the right choice of treatment and in the early initiation of palliative care.
卵巢癌转移至中枢神经系统（CNS）较为罕见，特别是孤立性脑膜转移（LM）极为罕见。脑膜癌病（LC）诊断的金标准是脑脊液（CSF）细胞学检查中发现恶性细胞。一位 58 岁的女性，2 年前被诊断出患有卵巢癌，近几个月因新出现的下肢无力、无力和言语障碍而接受了腰椎穿刺和 CSF 细胞学检查。同时可视化中枢神经系统的磁共振成像，并显示线性脑膜增强。CSF 细胞学显示肿瘤细胞为孤立细胞或小簇肿瘤细胞，具有大的、部分空泡化的和丰富的细胞质，大多数具有中央定位的核。鉴于她患有高级别透明细胞卵巢癌的病史，CSF 细胞学检查为恶性细胞阳性，神经肿瘤多学科肿瘤委员会做出了脑膜癌病的诊断。由于 LM 也意味着全身性疾病，预后非常差，CSF 细胞学将在快速诊断中发挥重要作用，无论是在正确选择治疗方法还是在早期开始姑息治疗方面都将是有用的。
