Brain metastases from fallopian tube carcinoma responsive to intra-arterial carboplatin and intravenous etoposide: a case report.
Fallopian tube carcinoma is the least common neoplasm of the female genital tract. Although rare, neurological complications such as brain metastases can develop. It remains unclear, however, what role chemotherapy has in the treatment of these patients and what route of administration is most effective. Intra-arterial (IA) regional administration of chemotherapy may increase intra-tumoral drug concentrations and improve efficacy. We report the case of a 47-year-old woman who developed bilateral fallopian tube cancer and multifocal brain metastases. After progression through radiation therapy and oral chemotherapy, she was placed on IA carboplatin (200 mg/m2/d x 2 days every 4 weeks) and intravenous etoposide (100 mg/m2/d x 2 days every 4 weeks). During treatment she had objective tumor shrinkage that has remained stable for more than 12 months. For patients with fallopian tube carcinoma that develop brain metastases and respond poorly to surgery and/or irradiation, multi-agent chemotherapy containing carboplatin should be considered. The effectiveness of carboplatin may be improved if administered by the IA route.
Newton
H B
HB
Department of Neurology, The Ohio State University Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio, USA. newton.12@osu.edu
Stevens
C
C
Santi
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M
D000231:Adenocarcinoma, Papillary / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D001933:Brain Stem / Q000473:pathology*; D016190:Carboplatin / Q000008:administration & dosage; D002339:Carotid Arteries; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003520:Cyclophosphamide / Q000008:administration & dosage; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage; D005185:Fallopian Tube Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D005187:Fallopian Tubes / Q000293:injuries; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010808:Physical Examination / Q000009:adverse effects; D012422:Rupture, Spontaneous; D000077204:Temozolomide; D013702:Temporal Lobe / Q000473:pathology*; D014711:Vertebral Artery
D018906:Antineoplastic Agents, Alkylating; D005047:Etoposide; D003606:Dacarbazine; D003520:Cyclophosphamide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D000077204:Temozolomide