We experienced two rare cases of
metastases to the central nervous system (cerebral and leptomeningeal
metastases) from primary
epithelial ovarian carcinoma. The first case was a 55-year-old woman who developed
carcinomatous meningitis while on
chemotherapy for
ovarian cancer stage IIIC. Cytological analysis confirmed carcinomatous cells of ovarian origin in the cerebrospinal fluid. Magnetic resonance imaging demonstrated abnormal hyperintensity in the cerebral sulci on fluid attenuated inversion recovery (FLAIR) sequence with enhanced
gadolinium indicating leptomeningeal
metastases. Her consciousness rapidly declined and she died 42 days after diagnosis. The second case was a 63-year-old woman who underwent surgery for
ovarian cancer and who was diagnosed as stage IA. Thirty-eight months after surgery, she developed weakness of the left hand and
headaches. A CT scan revealed
metastases to the right cerebrum and she was treated with surgical resection followed by
radiotherapy. Five months after resection, she developed
ileus caused by multiple relapses in the pelvis. Despite
chemotherapy, her performance status declined and she died nine months after the resection. Both cases were rare because the first case was isolated leptomeningeal
metastases, and the second case was confirmed relapse site in the cerebrum due to neurological symptoms despite her early clinical stage.