Leptomeningeal metastasis from ovarian carcinoma successfully treated by the intraventricular administration of methotrexate

Journal International Journal of Clinical Oncology

Publisher Springer Japan
ISSN 1341-9625 (Print) 1437-7772 (Online)
Issue Volume 13, Number 6 / December, 2008
Category Case Report
DOI 10.1007/s10147-008-0782-2
Pages 555-558
Subject Collection Medicine

SpringerLink Date Thursday, December 18, 2008

Yasushi Goto1, Noriyuki Katsumata1 , Shunichi Nakai2, Yuko Sasajima3, Kan Yonemori1, Tsutomu Kouno1, Chikako Shimizu1, Masashi Ando1 and Yasuhiro Fujiwara1(1) Breast and Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
(2) Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan
(3) Diagnostic Pathology Division, National Cancer Center Hospital, Tokyo, Japan


Received: 24 November 2007 Accepted: 17 March 2008 Published online: 18 December 2008
Abstract A 60-year-old woman with a history of ovarian carcinoma and complaining of gait instability, dizziness, nausea, and a right temporal headache visited a neurologist. A diagnosis of leptomeningeal metastasis was made, based on the results of a cerebrospinal fluid examination. After the administration of intrathecal methotrexate, her neurological complaints disappeared. An Ommaya intraventricular reservoir was inserted, and methotrexate administration was continued for 11 months, until another recurrence was found in her pelvis. Although uncommon, the possibility of leptomeningeal metastasis from ovarian carcinoma should be considered; in such cases, treatment with intraventricular methotrexate may be effective and feasible and should be considered as a treatment strategy.

Key words Leptomeningeal metastasis - Ovarian carcinoma - Intrathecal chemotherapy - Methotrexate