Central nervous system metastases in patients with ovarian carcinoma

BACKGROUND: Central nervous system (CNS) involvement by ovarian carcinomais rare. PATIENTS AND METHODS: From September 1982 to September 1994, 23 patients with CNSmetastases from ovarian carcinoma were observed in our institution. RESULTS: Their median age at the time of CNS metastasis diagnosis was59 years, and the median interval between diagnosis of ovariancancer and documentation of the metastasis was 35 months. Themost common symptoms related to CNS involvement were motor weakness,headache, seizures, dizziness and visual disturbances. One patienthad meningeal carcinomatosis; 22 had parenchyma] lesions (18cerebral and 4 cerebellar). Nine patients had a single CNS lesion,and 13 had multiple metastatic sites. CNS was the only siteof disease in 9 patients, while 8 had concomitant extra-peritonealdissemination. The median survival (MS) from diagnosis of cerebralmetastases for the entire series was five months. Four patientswere not treated (MS 3 months); 14 received radiotherapy (MS5.5 months), and five underwent surgical resection of solitarymetastases followed by radiotherapy (MS 17 months). Number ofCNS lesions, extent of the disease at the time of CNS metastasisand treatment were the only factors which significantly affectedsurvival. CONCLUSIONS: The prognosis of patients with CNS metastasis from ovarian carcinomaappears poor. However, early diagnosis followed by multimodaltreatment may result in significant palliation and improve overallsurvival in a selected group of patients. central nervous system metastasis, ovarian carcinoma