A 64-year-old female came to our clinic with an ataxic gait, episodes of syncope, postprandial emesis, and intense pain in the occipital region lasting 4 days. The patient had a history of substance abuse and smoking (smoking index (SI) = 13.5; SI = (Cigarettes per day) × (Years of smoking); an SI of 200 or more is considered moderate to heavy smoking), which she discontinued 15 years ago. She was diagnosed with serous ovarian carcinoma 1 year ago and is currently undergoing chemotherapy treatment. Upon physical examination, weakness was noted in the upper limbs, with muscle strength graded at 2/5 on the Daniels scale. Laboratory studies showed elevated ovarian tumor marker CA-125. CT and MRI revealed a hypodensity in the left lobe of the cerebellum with irregular borders and hydrocephalus due to compression (Fig. 1A, B). A complete resection was performed with suboccipital craniotomy and placement of a ventriculoperitoneal shunt. Histopathological study revealed a malignant neoplasm of epithelial lineage with characteristics of ovarian carcinoma and positive immunohistochemistry for PAX-8, confirming the diagnosis of primary ovarian carcinoma with metastasis to the cerebellum. Currently, the patient is undergoing treatment with chemotherapy and radiation therapy (carboplatin and paclitaxel regimen-conventional radiation therapy) and is being evaluated for metastasis in other regions, showing a good clinical response.
Brain MRI in parasagittal (A) and axial (B) sections shows a lesion in the left cerebellar hemisphere measuring approximately 6 × 3 cm (asterisks). T1 (A) shows heterogeneous enhancement, with a cystic component and perilesional edema (asterisk). T2 (B) shows the same lesion as hyperintense (asterisk), with compression of adjacent structures.
Patient written informed consent was obtained.
Ethical committeeComité de Investigación de la UDEM.
Registry number29052024-CARD-CI.
