Silent Threat: Delayed Brain Metastasis After Successful Ovarian Cancer Therapy

Brain metastases from ovarian carcinoma are a rare occurrence, with an incidence rate ranging from 0.49% to 6.1% of cases. These metastases are often associated with a poor prognosis, with a median survival time ranging from 2 to 10 months following diagnosis. Several factors influence the prognosis, including the patient's age, overall performance status, the extent of extracranial disease, and the presence of multiple brain metastases. We describe the case of a 52-year-old woman with a history of stage III ovarian carcinoma diagnosed and treated in 2014. After a decade of remission, she presented with neurological symptoms in 2024, including headaches, seizures, and right-sided weakness. Imaging revealed two separate brain lesions in the left parietal lobe and right cerebellar hemisphere. Both lesions were treated with hypofractionated stereotactic radiotherapy (SRT), delivering 27 Gy in three sessions and 30 Gy in five sessions, respectively. The treatment plan was briefly paused due to intracranial pressure but was successfully completed after symptom management with corticosteroids and mannitol. Post-treatment, the patient experienced symptomatic relief, and adjuvant chemotherapy with Temozolomide was initiated. Hypofractionated SRT is a viable option for managing brain metastases from ovarian carcinoma, but individualized care and multidisciplinary approaches remain essential to address complications and improve outcomes.