Intramedullary Spinal Cord Metastasis from Ovarian Carcinoma

Cormio, Gennaro; Vagno, Giovanni Di; Fazio, Franco Di; Loverro, Giuseppe; Selvaggi, Luigi

doi:10.1006/gyno.2000.6186

Cited by 19 publications

(12 citation statements)

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“…In select cases, simultaneous steroids and radiotherapy administration without a tissue diagnosis can be considered for patients at high surgical risk with poor Karnovsky scores [6,7]. Cormio et al [8] demonstrated complete resolution of neurological symptoms with early steroids and carboplatin. Prior to the fourth cycle of carboplatin, an MRI scan of the brain showed diffuse metastatic disease for which the patient received 30Gy radiotherapy to the brain and cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the literature

et al. 2011

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IntroductionCurrently there is no generalized approach to treating patients with intra-medullary spinal metastasis. High cervical spinal cord lesions can be particularly challenging cases, and may even be considered inoperable by some.Case reportWe present what is, to the best of our knowledge, the first reported case of ovarian carcinoma (managed primarily with surgery) in a 65-year-old Caucasian woman metastasizing to the upper cervical spinal cord; we also review the relevant literature and discuss management strategies.ConclusionsDue to improving systemic cancer therapies, patients with cancer now often survive longer and are more likely to develop central nervous system metastases. Therefore, neurosurgical oncologists are often challenged with difficult decisions about how to surgically manage these patients. We recommend individualized multidisciplinary management based on patient functional status, the need for definitive diagnosis for possible additional adjuvant therapies, and consideration of extent of systemic disease impacting on desirable quality and length of survival.

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Section: Discussionmentioning

confidence: 99%

Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the literature

et al. 2011

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“…In 1987 Dauplat and colleagues reported their experience on 255 patients and found that distant metastases developed in 97 patients (38%) at some time during the natural history of the disease ( 4 ) . Distant metastases theoretically may occur anywhere (10) ; however, pleura( 4,11 ), liver ( 11 ) , lungs ( 12 ) , central nervous system( 13,14 ), spleen ( 15 ) , skin ( 11 ) , bone ( 16 ) , and breast ( 17 ) are in order the most commonly involved sites. In our study distant metastases were present in 8% of the patients at the time of diagnosis and in 22% of the patients during the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Distant metastases in ovarian carcinoma

Cormio

Rossi

Cazzolla

et al. 2003

Int J Gynecol Cancer

170

140

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Distant metastases are unusual at presentation and during the course of ovarian carcinoma. The aim of the present study was to determine the incidence and prognostic factors of distant metastases consistent with stage IV disease in ovarian cancer patients. A retrospective chart review was conducted on 162 patients with epithelial ovarian carcinoma treated at our Unit between 1991 and 2000. Pertinent clinical information, pathologic data, treatment, and prognostic factors for survival following documentation of distant metastatic disease were collected. The significance of the association between metastatic status and various clinical variables was assessed using the standard chi-square test. Survival time was calculated from the time of diagnosis of ovarian cancer and from the time of diagnosis of the distant metastases. A logistic regression procedure was used to estimate the odds of metastatic status given the presence of certain clinical variables. A total of 67 metastatic sites were diagnosed in 50 patients. Thirteen patients (8%) had distant metastatic disease at the time of diagnosis, 37 patients (22%) had distant metastases at the time of recurrent of progressive disease. Site of metastases were: liver, 21; pleura, 11; lung, 8; central nervous system and skin, 7 each; extra-abdominal lymph nodes and spleen, 5 each; bone, 2; and breast, 1. Significant risk factors for the development of distant metastases were stage, grade, and lymph node involvement. Median interval time between diagnosis of ovarian cancer and documentation of metastatic disease was 44 months (range 3-105), and at the time of diagnosis of distant disease, 36 of 50 patients (72%) had other sites of disease (intra-abdominal or extra-abdominal). Median survival from diagnosis of distant disease was 12 months (range 1-58). In univariate analysis performance status (P = 0.03), the presence of other sites of disease (P = 0.04) and interval time between diagnosis of ovarian cancer and documentation of distant metases (P = 0.03) were the only factors significantly associated with survival. Long interval time remained significant for prognosis in multivariate analysis also (P = 0.04). Distant metastasis consistent with stage IV disease is a late complication that occurs in about one third of ovarian cancer patients. Prognosis after documentation of distant metastases is poor. We conclude the most important prognostic factor associated with survival is the interval time between diagnosis of ovarian cancer and documentation of distant metastases.

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“…Distant metastases theoretically may occur anywhere (10) ; however, pleura (4,11) , liver (11) , lungs (12) , central nervous system (13,14) , spleen (15) , skin (11) , bone (16) , and breast (17) are in order the most commonly involved sites. In our study distant metastases were present in 8% of the patients at the time of diagnosis and in 22% of the patients during the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Distant metastases in ovarian carcinoma

Cormio

Rossi

Cazzolla

et al. 2003

Int J Gynecol Cancer

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Distant metastases are unusual at presentation and during the course of ovarian carcinoma. The aim of the present study was to determine the incidence and prognostic factors of distant metastases consistent with stage IV disease in ovarian cancer patients. A retrospective chart review was conducted on 162 patients with epithelial ovarian carcinoma treated at our Unit between 1991 and 2000. Pertinent clinical information, pathologic data, treatment, and prognostic factors for survival following documentation of distant metastatic disease were collected. The significance of the association between metastatic status and various clinical variables was assessed using the standard chi-square test. Survival time was calculated from the time of diagnosis of ovarian cancer and from the time of diagnosis of the distant metastases. A logistic regression procedure was used to estimate the odds of metastatic status given the presence of certain clinical variables. A total of 67 metastatic sites were diagnosed in 50 patients. Thirteen patients (8%) had distant metastatic disease at the time of diagnosis, 37 patients (22%) had distant metastases at the time of recurrent of progressive disease. Site of metastases were: liver, 21; pleura, 11; lung, 8; central nervous system and skin, 7 each; extra-abdominal lymph nodes and spleen, 5 each; bone, 2; and breast, 1. Significant risk factors for the development of distant metastases were stage, grade, and lymph node involvement. Median interval time between diagnosis of ovarian cancer and documentation of metastatic disease was 44 months (range 3–105), and at the time of diagnosis of distant disease, 36 of 50 patients (72%) had other sites of disease (intra-abdominal or extra-abdominal). Median survival from diagnosis of distant disease was 12 months (range 1–58). In univariate analysis performance status (P = 0.03), the presence of other sites of disease (P = 0.04) and interval time between diagnosis of ovarian cancer and documentation of distant metases (P = 0.03) were the only factors significantly associated with survival. Long interval time remained significant for prognosis in multivariate analysis also (P = 0.04). Distant metastasis consistent with stage IV disease is a late complication that occurs in about one third of ovarian cancer patients. Prognosis after documentation of distant metastases is poor. We conclude the most important prognostic factor associated with survival is the interval time between diagnosis of ovarian cancer and documentation of distant metastases.

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Intramedullary Spinal Cord Metastasis from Ovarian Carcinoma

Cited by 19 publications

References 18 publications

Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the literature

Upper cervical intramedullary spinal metastasis of ovarian carcinoma: a case report and review of the literature

Distant metastases in ovarian carcinoma

Distant metastases in ovarian carcinoma

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