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Case Report Open Access

Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report

  • Authors:
    • Chihiro Ishizawa
    • Kazunari Miyazawa
    • Misaki Tani
    • Kazuaki Neriishi
    • Yukari Kambe
    • Akira Tsuchiya
  • View Affiliations / Copyright

    Affiliations: Department of Obstetrics and Gynecology, Showa General Hospital, Tokyo 187‑8510, Japan, Department of Radiology, Showa General Hospital, Tokyo 187‑8510, Japan
    Copyright: © Ishizawa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 4
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    Published online on: October 23, 2025
       https://doi.org/10.3892/ol.2025.15357
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Abstract

Brain metastasis from ovarian cancer, particularly from clear cell ovarian cancer, is extremely rare and its pathology remains unclear. In the present study we treated a patient in whom this cancer was diagnosed after chemotherapy was administered for lung metastases. The patient, a 76‑year‑old woman, presented to Department of Obstetrics and Gynecology,  Showa General Hospital (Tokyo, Japan)  in February 2025 with sudden confusion and dizziness. The patient was surgically treated for ovarian cancer 20 years previously that displayed two clear histological types: Left clear cell and mucinous carcinomas and right endometrioid carcinoma. The patient was treated several times for recurrent metastases in the umbilicus and inguinal lymph nodes, of either clear cell or endometrioid carcinoma. The treatment administered varied from resection to radiotherapy. In 2016, lung metastasis was suspected, but the lesion size remained unchanged for several years. In 2019, the left inguinal lymph node again became swollen, and re‑irradiation was performed for 2 weeks. In 2023, the right lung metastases grew larger and palliative radiotherapy was administered at another hospital. The right lung metastases continued to grow, and the patient returned to our hospital in May 2024 with a severe cough; metastasis from ovarian cancer was diagnosed. Paclitaxel‑carboplatin chemotherapy was resumed for 6 months; the tumor grew slightly smaller, and the severe cough disappeared. The patient underwent maintenance olaparib therapy from January 2025 for platinum‑sensitive recurrent ovarian cancer. After presenting to our department in February 2025, imaging studies revealed multiple substantial brain metastases and growth of the lung metastases. Palliative whole brain radiotherapy was administered, with the confusion improving slightly. The patient was transferred to a nursing home. Multiple pathological types coexisted in our patient, creating a complicated condition that, after various treatments were administered, was difficult to comprehend. Appropriate pathological diagnosis through biopsy, as well as comprehensive consideration of the treatment strategy based on the characteristics of the pathological type, is necessary.
View Figures

Figure 1

Image of the resected specimens
obtained via abdominal bilateral salpingo-oophorectomy.
Endometrioid carcinoma was diagnosed in the right ovary, and clear
cell and mucinous carcinomas were diagnosed in the left ovary.
Scale bar, 5 cm.

Figure 2

Image showing the resected specimen
of the clear cell carcinoma in the umbilicus. Scale bar, 1 cm.

Figure 3

Computed tomography images of the
lungs captured between June 2016 and November 2024. (A) The sizes
of the right lung metastases were constant for several years. (B)
The lung metastases in the right lung were significantly larger in
March 2023 than they were in June 2016. After chemotherapy was
administered, the right lung metastases were smaller (lung
metastases encircled in red). Scale bar, 5 cm.

Figure 4

T2-weighted magnetic resonance images
of the head, before radiation therapy. Multiple brain metastases
are visible (arrowheads indicate metastatic brain lesions).

Figure 5

Fluid-attenuated inversion recovery
magnetic resonance images of the head, before and after
radiotherapy in February 2025. The images show slight narrowing of
the lateral ventricles, with some improvement in the hydrocephalus
(arrowhead indicates the lateral ventricles.). FLAIR,
fluid-attenuated inversion recovery.
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Copy and paste a formatted citation
Spandidos Publications style
Ishizawa C, Miyazawa K, Tani M, Neriishi K, Kambe Y and Tsuchiya A: Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report. Oncol Lett 31: 4, 2026.
APA
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., & Tsuchiya, A. (2026). Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report. Oncology Letters, 31, 4. https://doi.org/10.3892/ol.2025.15357
MLA
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., Tsuchiya, A."Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report". Oncology Letters 31.1 (2026): 4.
Chicago
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., Tsuchiya, A."Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report". Oncology Letters 31, no. 1 (2026): 4. https://doi.org/10.3892/ol.2025.15357
Copy and paste a formatted citation
x
Spandidos Publications style
Ishizawa C, Miyazawa K, Tani M, Neriishi K, Kambe Y and Tsuchiya A: Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report. Oncol Lett 31: 4, 2026.
APA
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., & Tsuchiya, A. (2026). Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report. Oncology Letters, 31, 4. https://doi.org/10.3892/ol.2025.15357
MLA
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., Tsuchiya, A."Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report". Oncology Letters 31.1 (2026): 4.
Chicago
Ishizawa, C., Miyazawa, K., Tani, M., Neriishi, K., Kambe, Y., Tsuchiya, A."Brain metastasis of ovarian cancer >20 years after initial diagnosis: A case report". Oncology Letters 31, no. 1 (2026): 4. https://doi.org/10.3892/ol.2025.15357
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