Isolated Thoracic Spine Intramedullary Metastasis from Primary Ovarian Carcinoma: A Rare Case Report

Ovarian carcinoma is one among the most commonly diagnosed cancer in women. Most commonly it metastasizes within peritoneal cavity by transcoelomic spread; distant metastasis to central nervous system through hematogenous spread is rare, and intramedullary spread is even rarer. Till date, only six reports have identified isolated intramedullary metastasis to spinal cord in a patient who were considered disease free on follow-up after treatment of primary disease; of which only two were in dorsal spine. The average time for diagnosis of intramedullary metastasis after diagnosis of primary disease was 26 months in previous reports. All were on regular follow-up, and clinicians were misleaded by normal CA-125 levels, and patients were considered disease free. This report is third in world literature case of isolated intramedullary dorsal spinal cord metastasis in a patient of primary ovarian carcinoma who was on follow-up with normal CA-125 levels and was treated with myelotomy and gross total resection of lesion + adjuvant chemotherapy and oral steroids. With our experience, we recommend keeping magnetic resonance imaging neuraxis to be done in follow-up of patients treated for high-grade ovarian carcinoma so that early diagnosis and prompt management can be given to patients that can improve their quality of life.