Brain Metastases from Epithelial Ovarian Cancer: A Review of the Literature

Abstract

Key Words. Brain metastases • Surgery • Stereotactic radiosurgery • Whole-brain radiotherapy • Chemotherapy Learning ObjectivesAfter completing this course, the reader will be able to:1. Select the appropriate treatment strategies for ovarian cancer patients with solitary brain metastases and extracranial disease.2. Describe the most important prognostic factors for ovarian cancer patients with brain metastases.3. List the diagnostic steps needed to establish the diagnosis of brain metastases in ovarian cancer patients.

Treatment and Prognosis of Brain Metastases From Gynecological Cancers

“…This is consistent with other studies with the reported rates of 0.3-2.2% for ovarian cancer and 0.6-0.9% for other cancers. 1 19,32) The use of effective combination chemotherapy, especially regimens containing cisplatin for ovarian cancer, may increase survival, providing time for occult brain metastases to become overt. Another explanation for the possible increase in brain metastases is the availability of better imaging techniques for diagnosis.…”

“…Another explanation for the possible increase in brain metastases is the availability of better imaging techniques for diagnosis. 32) Further studies are required to monitor whether incidence rates among these patients will continue to increase in the future.…”

“…Therefore, clinical reports of brain metastases from gynecological cancers have increased gradually. 19,32) The present study evaluated our experience with brain metastases from gynecological cancers to identify the treatments and factors that influence the prognosis of these patients.…”

Central Nervous System Involvement from Epithelial Ovarian Cancer

“…Other symptoms that are often described are vomiting, confusions, visual disturbances, paresis, and weakness, loss of consciousness, seizures, and dizziness. (Cohen, 2004;Cormio, 2011a;D'Andrea, 2005;Lee, 2008;Pectasides, 2006;Tay &Rajesh, 2005) The leptomeningeal involvement usually causes an arise of the intracranial pressure associated with hydrocephalus; these patients more frequently than the others complain also for bowel of bladder dysfunctions, while the involvement of cranial nerves can also be possible. (Pectasides, 2006;Vitaliani R, 2009) In our recent series of 20 patients, all patients were symptomatic at the moment of the diagnosis; most of them complain of headache, vomiting and dizziness with or without balance disturbances, less frequent symptoms were diplopia, convulsions, amnesia, confusion and pain.…”

“…The two image techniques are both effective, even if MRI seems to be the modality of choice because it has an higher resolution than CT scan, it is able to detect lesions as small as 1,9 mm; moreover MRI seems to be more effective especially for the image study of the lesions localized in the posterior fossa. (Pectasides, 2006). In a CT scan, metastatic lesions appear as ring areas, singular or multiple, slightly hyper dense, homogeneous or not and commonly surrounded by oedema.…”