Leptomeningeal Carcinomatosis From Primary Mucinous Carcinoma of the Ovary

Abstract

Leptomeningeal carcinomatosis (LMC) is an extremely rare site for metastasis from a primary ovarian cancer. LMC occurs when the thin layers of tissue that surround the brain and spinal cord are infiltrated by ovarian cancer metastasis. We present a case of a 63-year-old female with recurrent metastatic mucinous adenocarcinoma of the ovary who was diagnosed with LMC. While undergoing sixth-line chemotherapy, she presented with debilitating headaches and gait instability. Brain MRI revealed subarachnoid enhancement and other findings diagnostic of LMC. Given the rarity of this disease, treatment protocols have yet to be established. In patients with primary ovarian cancer that present with new onset neurological complaints, LMC should be suspected and appropriate imaging obtained.

Keywords: brain metastases; leptomeningeal carcinomatosis; management; ovarian cancer; surgery; treatment.

Figure 1. MRI of the brain. Pre-contrast T1-weighted sequence (a) demonstrating no hyperintense signal within the cerebellum. Post-contrast T1-weighted sequence (b) showing leptomeningeal enhancement within the cerebellar folia (white arrows). Post-contrast T1-weighted sequence (c) showing nodular small foci of enhancement (white arrow) concerning for solid intraparenchymal metastasis.