Advanced ovarian dysgerminoma with cure of tumor persistent in meninges.
Isolated meningeal recurrence of ovarian cancer is uncommon. It is generally assumed that such cases are not accompanied by prolonged survival. We report the cure of a patient with advanced ovarian dysgerminoma who developed febrile carcinomatous meningitis 2 weeks after receiving her fifth course of combination chemotherapy (5 months after initiation of chemotherapy). No parenchymal brain disease was identified. The persistence of disease in the leptomeninges is related to the ability of the blood-brain barrier to exclude chemotherapeutic agents. The patient responded to craniospinal radiation and remains free of disease 2 years after completion of treatment.
Jolles
C J
CJ
Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City 84132.
Karayianis
S
S
Smotkin
D
D
DeLia
J E
JE
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001812:Blood-Brain Barrier; D003131:Combined Modality Therapy; D004407:Dysgerminoma / Q000134:cerebrospinal fluid / Q000556:secondary / Q000628:therapy*; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000532:radiotherapy* / Q000556:secondary; D010051:Ovarian Neoplasms / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D012074:Remission Induction