Abstract
Summary: Brain metastasis is a rare and generally late manifestation of an advanced-stage, high-grade serous ovarian carcinoma. Nowadays, the improved control of intra-abdominal disease by surgery and platinum-based chemotherapy results in a longer survival, allowing distant metastasis to implant and grow in the brain parenchyma also. Herein, we describe a unique case of cerebellar metastasis from a particular type of ovarian tumor, clear cell that initially presented as a FIGO Stage IC cancer. Surprisingly, 6 mo after surgery, the patient shows good general conditions with complete disappearance of symptoms and no evidence of recurrence. This relatively good biologic behavior may be explained by the presence of PIK3CA-activating mutation in exon 9 which as previously reported in the literature, may be associated with better prognosis. To the best of our knowledge, this is the first reported case of cerebellar metastasis from ovarian clear cell carcinoma. In the presence of neurological symptoms, both clinicians and pathologists must be aware of this rare possibility, to assure the patient correct management and effective therapeutic options. Generally, the prognosis of epithelial ovarian cancer patients with brain metastases is poor. PIK3CA mutations could be a good prognostic indicator in clear cell carcinomas.
| Original language | English |
|---|---|
| Journal | International Journal of Gynecological Pathology |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- Brain metastasis
- Chemotherapy
- Ovarian cancer
- PIK3CA-activating mutation
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Obstetrics and Gynaecology
Cite this
Cerebellar metastasis from ovarian carcinoma harboring PIK3CA-activating mutation : A “clear” explanation for an unexpected “vertigo”. / Piermattei, Alessia; Santoro, Angela; Angelico, Giuseppe; Inzani, Frediano; Valente, Michele; Pettinato, Angela; Vatrano, Simona; Scambia, Giovanni; Fraggetta, Filippo; Zannoni, Gian Franco.
In: International Journal of Gynecological Pathology, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cerebellar metastasis from ovarian carcinoma harboring PIK3CA-activating mutation
T2 - A “clear” explanation for an unexpected “vertigo”
AU - Piermattei, Alessia
AU - Santoro, Angela
AU - Angelico, Giuseppe
AU - Inzani, Frediano
AU - Valente, Michele
AU - Pettinato, Angela
AU - Vatrano, Simona
AU - Scambia, Giovanni
AU - Fraggetta, Filippo
AU - Zannoni, Gian Franco
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Summary: Brain metastasis is a rare and generally late manifestation of an advanced-stage, high-grade serous ovarian carcinoma. Nowadays, the improved control of intra-abdominal disease by surgery and platinum-based chemotherapy results in a longer survival, allowing distant metastasis to implant and grow in the brain parenchyma also. Herein, we describe a unique case of cerebellar metastasis from a particular type of ovarian tumor, clear cell that initially presented as a FIGO Stage IC cancer. Surprisingly, 6 mo after surgery, the patient shows good general conditions with complete disappearance of symptoms and no evidence of recurrence. This relatively good biologic behavior may be explained by the presence of PIK3CA-activating mutation in exon 9 which as previously reported in the literature, may be associated with better prognosis. To the best of our knowledge, this is the first reported case of cerebellar metastasis from ovarian clear cell carcinoma. In the presence of neurological symptoms, both clinicians and pathologists must be aware of this rare possibility, to assure the patient correct management and effective therapeutic options. Generally, the prognosis of epithelial ovarian cancer patients with brain metastases is poor. PIK3CA mutations could be a good prognostic indicator in clear cell carcinomas.
AB - Summary: Brain metastasis is a rare and generally late manifestation of an advanced-stage, high-grade serous ovarian carcinoma. Nowadays, the improved control of intra-abdominal disease by surgery and platinum-based chemotherapy results in a longer survival, allowing distant metastasis to implant and grow in the brain parenchyma also. Herein, we describe a unique case of cerebellar metastasis from a particular type of ovarian tumor, clear cell that initially presented as a FIGO Stage IC cancer. Surprisingly, 6 mo after surgery, the patient shows good general conditions with complete disappearance of symptoms and no evidence of recurrence. This relatively good biologic behavior may be explained by the presence of PIK3CA-activating mutation in exon 9 which as previously reported in the literature, may be associated with better prognosis. To the best of our knowledge, this is the first reported case of cerebellar metastasis from ovarian clear cell carcinoma. In the presence of neurological symptoms, both clinicians and pathologists must be aware of this rare possibility, to assure the patient correct management and effective therapeutic options. Generally, the prognosis of epithelial ovarian cancer patients with brain metastases is poor. PIK3CA mutations could be a good prognostic indicator in clear cell carcinomas.
KW - Brain metastasis
KW - Chemotherapy
KW - Ovarian cancer
KW - PIK3CA-activating mutation
UR - http://www.scopus.com/inward/record.url?scp=85054204718&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054204718&partnerID=8YFLogxK
U2 - 10.1097/PGP.0000000000000550
DO - 10.1097/PGP.0000000000000550
M3 - Article
AN - SCOPUS:85054204718
JO - International Journal of Gynecological Pathology
JF - International Journal of Gynecological Pathology
SN - 0277-1691
ER -