Cauda equina syndrome in an ovarian malignant‐mixed müllerian tumor with leptomeningeal spread

Abstract

Leptomeningeal metastasis is extremely rare in patients with ovarian cancer, but should be considered in patients presenting with neurologic deficits such as cauda equine syndrome. Given its poor prognosis and lack of data currently on management, additional studies are needed to optimize treatment regimens and improve outcomes.

Leptomeningeal Metastases of the Spine: A Systematic Review

“…However, as these symptoms may also occur in other benign or malignant conditions, including intervertebral disc herniation or vertebral fracture, patients' history of oncological disease and systemic metastases should be investigated to plan appropriate metastatic diagnostic protocols (71,72). The occurrence of cauda equina syndrome has also been largely reported across our included studies (51,(54)(55)(56). This likely owes to the fact that CSF circulation is slower in the cauda equina and the basilar cisterns, which represent the two regions mostly affected by leptomeningeal seeding (66, 67).…”

“…Secondary systemic metastases preceding the onset of spine LMs were detected in 39 patients (54.9%), most frequently occurring in the brain parenchyma (38.9%) and/or regional lymph nodes (18.1%). Metastatic peritoneal seeding was described in 4 patients with gynecological neoplasms (22,50,51,63) and 1 patient with gastric adenocarcinoma (27). While primary tumors were treated with variable cancer-specific multidisciplinary strategies including surgery, adjuvant chemotherapy, and radiation, brain metastases were preferentially treated with conventional or stereotactic radiotherapy (66.7%) and/or surgical resection when feasible (60%).…”