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2020 article

Î Rare Solitary Spinal Cord Metastasis after Epithelial Ovarian Cancer Diagnosis

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Ovarian cancer is frequently diagnosed at an advanced stage, with an unfavourable five-year survival. The standard therapeutic approach includes cytoreductive surgery and platinum-based chemotherapy. Relapse and metastasis, frequently occurring within the first two years after diagnosis involves the abdominal cavity. Herein, a patient with stage IIIc, high grade serous peritoneal carcinomatosis, who was diagnosed with a secondary, solitary intramedullary lesion seventeen months after the initial diagnosis and treatment, is presented. The patient underwent R1 operation to remove the mass, with cerebrospinal fluid being tested positive for the presence of tumor cells, while the serous origin of the tumor was confirmed by the histology report. Testing of both the primary and the secondary tumors was performed, where a pathogenic TP53 variant was identified. In the absence of an actionable variant, she subsequently received intrathecal methotrexate. Six months later, an MRI showed residual intramedullary disease and she received systemic chemotherapy but deceased two months later. Intramedullary cord involvement as a metastatic lesion following an ovarian cancer diagnosis remains rare. The multidisciplinary approach through which tumor molecular profiling will be performed and assessed may significantly increase both progression-free survival and quality of life of cancer patients.1

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