Leptomeningeal Carcinomatosis in Epithelial Ovarian Cancer: A Diagnostic Challenge

Cureus. 2021 Apr 12;13(4):e14440. doi: 10.7759/cureus.14440.

Abstract

Leptomeningeal carcinomatosis (LCM), also known as neoplastic meningitis, is a rare entity. It is generally seen in solid tumors. Ovarian cancers can infrequently cause LCM. The clinical presentation is variable. Diagnosis is made by a lumbar puncture that shows malignant cells in the cerebrospinal fluid (CSF) and usually correlates with imaging findings. Given the low individual sensitivities of lumbar puncture (55%) and magnetic resonance imaging (70%), it is recommended to combine both modalities for optimal diagnostic results. Treatment options vary depending on the type of primary carcinoma, however, the prognosis is guarded. We report a case of LCM in a patient with stage IV epithelial ovarian cancer in remission, which became a diagnostic challenge due to a lack of imaging findings.

Keywords: cerebrospinal fluid (csf); immunotherapy; intrathecal methotrexate; leptomeningeal carcinomatosis; lumbar puncture (lp); ovarian cancers.

Publication types

  • Case Reports