1995 Volume 34 Issue 4 Pages 670-674
The case of a 62-year-old woman suffering from ovarian carcinoma complicated with meningitis carcinomatosa is reported. She was diagnosed as having ovarian cancer (FIGO Stage IV) by CT scan, and by peritoneal and pleural fluid cytology. The first laparotomy was performed in November 1992, and was exploratory. After three courses of chemotherapy, a second laparotomy, in which we could remove almost the entire cancer mass with the uterus, omentum, and lymph nodes, was performed in February 1993. The histological diagnosis was ovarian serous cystadenocarcinoma without lymph node metastasis. After receiving another two courses of chemotherapy, she was discharged from the hospital in April 1993. She soon developed headaches and diplopy, and was readmitted. There were no remarkable findings of brain metastasis by CT scan and MRI. In the cytological examination of spinal fluid, however, small papillary masses formed by adenocarcinoma cells, showed metastatic meningitis carcinomatosa.The patient diedabout two weeks after the diagnosis. As a consequence of prolonged survival with improving chemotherapy, central nervous system metastasis from primary ovarian cancer is increasing. Spinal fluid cytology is one of the most effective methods, of early diagnosis.
