Rapid Development of Brain Metastases in Poorly Differentiated Cervical Squamous Cell Carcinoma: A Rare Case Report

Brain metastases from cervical cancer are exceedingly rare, with an incidence of 0.4% to 2.3%. Poorly differentiated histologic subtypes, particularly those with lymphovascular space invasion (LVSI) and parametrial involvement, may have a higher propensity for hematogenous spread. Current surveillance protocols do not routinely include brain imaging, potentially leading to delayed diagnosis in patients with early metastases. This case highlights an aggressive presentation of poorly differentiated squamous cell carcinoma (SCC) of the cervix with rapid brain metastases post-treatment, emphasizing the need for revised follow-up and therapeutic strategies.

A 46-year-old woman presented with postcoital bleeding and was diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIA1 poorly differentiated non-keratinizing SCC of the cervix. She underwent radical hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy, followed by adjuvant chemoradiotherapy. Despite initial disease control, she developed progressive neurological symptoms five months post-treatment. Brain imaging revealed multiple intracranial metastases, confirmed histologically as metastatic SCC. She un-derwent craniotomy and tumor resection, followed by palliative care due to extensive systemic involvement, including lung metastases.

This case highlights the limitations of current surveillance and treatment paradigms in high-risk cervical cancer patients. Earlier imaging and innovative systemic therapies with improved blood-brain barrier penetration may enhance patient outcomes. Future research should focus on refining post-treatment follow-up protocols and integrating novel therapeutic ap-proaches for metastatic cervical cancer.