Presentation
One month of headache with nausea and vomiting. Ataxic gait. Known history of ovarian cancer
Patient Data
Enhancing solid cystic mass with peripheral satellite nodules noted in the right cerebellar hemisphere. Small enhancing nodules also noted in the left cerebellar hemisphere. These cause herniation of the right cerebellar tonsil with effacement of fourth ventricle.
Case Discussion
Patient went on to have right posterior fossa craniotomy and resection of metastatic lesion. Intra-operatively, the metastatic lesion was noted to be multilobulated with a cystic component medially.
HISTOLOGY
MACROSCOPIC DESCRIPTION:
Multiple fragments of irregularly shaped light medium brown brain tissue 11g and 50 x 30 x 25mm in aggregate
MICROSCOPIC DESCRIPTION:
Sections demonstrate high grade metastatic carcinoma with a combination of solid and papillary and micropapillary architecture. The malignant cells have markedly pleomorphic nuclei with prominent nucleoli. The cells have a moderate amount of ampophilic cytoplasm with some hobnail forms seen. Areas of tumor necrosis are apparent. The tumor shows a sharp demarcation with adjacent cerebellar tissue
DIAGNOSIS:
Metastatic carcinoma - appearances consistent with origin from a high-grade ovarian serous carcinoma.
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