Ishizawa Chihiro, Miyazawa Kazunari, Tani Misaki, Neriishi Kazuaki, Kambe Yukari, Tsuchiya Akira
Department of Obstetrics and Gynecology, Showa General Hospital, Tokyo 187-8510, Japan.
Department of Radiology, Showa General Hospital, Tokyo 187-8510, Japan.
Oncol Lett. 2025 Oct 23;31(1):4. doi: 10.3892/ol.2025.15357. eCollection 2026 Jan.
Brain metastasis from ovarian cancer, particularly from clear cell ovarian cancer, is extremely rare and its pathology remains unclear. In the present study we treated a patient in whom this cancer was diagnosed after chemotherapy was administered for lung metastases. The patient, a 76-year-old woman, presented to Department of Obstetrics and Gynecology, Showa General Hospital (Tokyo, Japan) in February 2025 with sudden confusion and dizziness. The patient was surgically treated for ovarian cancer 20 years previously that displayed two clear histological types: Left clear cell and mucinous carcinomas and right endometrioid carcinoma. The patient was treated several times for recurrent metastases in the umbilicus and inguinal lymph nodes, of either clear cell or endometrioid carcinoma. The treatment administered varied from resection to radiotherapy. In 2016, lung metastasis was suspected, but the lesion size remained unchanged for several years. In 2019, the left inguinal lymph node again became swollen, and re-irradiation was performed for 2 weeks. In 2023, the right lung metastases grew larger and palliative radiotherapy was administered at another hospital. The right lung metastases continued to grow, and the patient returned to our hospital in May 2024 with a severe cough; metastasis from ovarian cancer was diagnosed. Paclitaxel-carboplatin chemotherapy was resumed for 6 months; the tumor grew slightly smaller, and the severe cough disappeared. The patient underwent maintenance olaparib therapy from January 2025 for platinum-sensitive recurrent ovarian cancer. After presenting to our department in February 2025, imaging studies revealed multiple substantial brain metastases and growth of the lung metastases. Palliative whole brain radiotherapy was administered, with the confusion improving slightly. The patient was transferred to a nursing home. Multiple pathological types coexisted in our patient, creating a complicated condition that, after various treatments were administered, was difficult to comprehend. Appropriate pathological diagnosis through biopsy, as well as comprehensive consideration of the treatment strategy based on the characteristics of the pathological type, is necessary.
卵巢癌脑转移，尤其是透明细胞卵巢癌脑转移极为罕见，其病理情况仍不明确。在本研究中，我们治疗了一名患者，该患者在因肺转移接受化疗后被诊断出患有这种癌症。患者为一名76岁女性，于2025年2月因突发意识模糊和头晕就诊于昭和综合医院妇产科（日本东京）。该患者20年前因卵巢癌接受手术治疗，病理显示有两种明确的组织学类型：左侧透明细胞癌和黏液性癌，右侧子宫内膜样癌。患者因脐部和腹股沟淋巴结复发转移（透明细胞癌或子宫内膜样癌）接受过多次治疗。治疗方式从切除到放疗不等。2016年，怀疑有肺转移，但病灶大小数年未变。2019年，左侧腹股沟淋巴结再次肿大，进行了为期2周的再次放疗。2023年，右肺转移灶增大，在另一家医院接受了姑息性放疗。右肺转移灶持续增大，患者于2024年5月因剧烈咳嗽返回我院；诊断为卵巢癌转移。恢复了6个月的紫杉醇-卡铂化疗；肿瘤略有缩小，剧烈咳嗽消失。该患者自2025年1月起因铂敏感复发性卵巢癌接受奥拉帕利维持治疗。2025年2月就诊于我科后，影像学检查显示有多处实质性脑转移和肺转移灶增大。进行了姑息性全脑放疗，意识模糊稍有改善。患者被转至养老院。我们的患者存在多种病理类型，病情复杂，经过各种治疗后，情况难以理解。通过活检进行恰当的病理诊断，以及根据病理类型特点综合考虑治疗策略是必要的。
