Brain metastases in ovarian cancer are uncommon, yet they signify aggressive disease and are associated with limited survival. This case highlights the diagnostic challenges and therapeutic dilemmas in managing central nervous system (CNS) involvement in ovarian cancer, given the lack of standardized protocols. This report adheres to the Surgical Case Report (SCARE) 2025 checklist. A 58-year-old woman with stage IIIB high-grade serous ovarian carcinoma in systemic remission developed a solitary frontal lobe metastasis 18 months after initial diagnosis. The diagnosis was suspected on MRI and confirmed by histopathological analysis after gross total resection of the tumor. While surgical intervention, as in this case, can provide symptomatic relief and pathological confirmation, the prognosis for patients with CNS metastases from ovarian cancer remains poor. This underscores the need for two key approaches in high-risk patients (e.g., those with residual postoperative tumor or unfavorable molecular markers): first, enhanced surveillance, implying more frequent imaging and a lower threshold for initiating adjuvant therapy, and second, the exploration of novel CNS-penetrating therapies. This case illustrates that even with aggressive local treatment for a solitary brain metastasis, outcomes are often unfavorable. It emphasizes the importance of a high index of suspicion for neurological symptoms in ovarian cancer patients and highlights the urgent need for more effective treatment strategies.
Cherif et al. (Thu,) studied this question.