Rapid manifestation of CNS metastatic disease in a cervical carcinoma patient: a case report.
OBJECTIVE
Brain metastases originating from primary cervical carcinoma are very rare. Despite surgery and adjuvant therapy, patient prognosis is extremely unfavorable. Prior studies have reported that the median time from the primary disease's diagnosis to development of CNS metastases is approximately 18 months.


METHODS
A 60-year-old woman was initially diagnosed and treated for FIGO clinical stage IB2 cervical carcinoma in March 2007. She underwent a radical hysterectomy, bilateral salpingo-oophorectomy and peri-aortic lymphadenectomy. Two weeks later, the patient presented with dysmetria and homonymous hemianopsia, which was related to a large right occipital CNS metastasis. The patient had surgery to resect the brain tumor and then received Gamma Knife stereotactic radiosurgery and chemotherapy. The neurological deficits were resolved and the patient's disease status has since remained stable, with five months of follow-up.


CONCLUSIONS
The incidence of brain metastases originating from primary cervical carcinoma is very rare. Furthermore, the occurrence of CNS metastatic disease manifesting itself within a couple weeks following diagnosis of the primary disease is even more unusual. Since the presenting symptoms of CNS metastatic disease are not well characterized and patient prognosis is very poor, oncology physicians should anticipate the presence of this condition in order to provide prompt and comprehensive treatment.
Brown Iii
John V
JV
Gynecologic Oncology Associates, Hoag Memorial Hospital, Newport Beach, Calif. 92663, USA.
Epstein
Howard D
HD
Kim
Richard
R
Micha
John P
JP
Rettenmaier
Mark A
MA
Mattison
Julie A
JA
Goldstein
Bram H
BH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy; D018196:Carcinoma, Adenosquamous / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D010052:Ovariectomy; D016634:Radiosurgery; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery