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263 A case of a 42 year-old filipina with cervical cancer with pathologically confirmed metastasis to the brain
  1. Jehan Ajibon Jabarani and
  2. Jehada-Inn Misuari Alihuddin
  1. Zamboanga City Medical Center, Zamboanga City, Philippines


Introduction/Background Cervical carcinomas are locally invasive tumors that spread primarily to the pelvic tissues and to the pelvic and paraaortic lymph nodes. Less commonly, hematogenous spread to the liver, lung and bone occurs. Brain metastasis from cervical cancer is rare with incidence reported ranging from 0.4% to 2.3%.

Methodology This is a case of 42 year-old multigravid Filipina, who presented with right sided weakness and headache. She complained of vaginal bleeding. On examination, she was confused with findings of facial asymmetry and decreased motor strength of 1/5 on the right upper and lower extremities. Pelvic examination revealed cervix converted to a 6 x 6 cm exophytic mass with posterior forniceal involvement, corpus small, no adnexal mass and tenderness, bilateral parametria nodular and fixed.

Results Cervical punch biopsy revealed a poorly differentiated carcinoma with squamoid features. Metastatic work-up was done. Brain MRI showed a 5.7 x 4.4 x 5.6 cm mass on the left frontoparietal region.

Patient underwent left frontotemporal craniectomy with excision of tumor for surgical decompression. Histopathologic report was the same with that of the cervix. Adjuvant treatment include high dose systemic chemotherapy concomitant with radiation to the brain.

Conclusion Cervical cancer metastasis to the brain carries a poor prognosis. Pathological confirmation of brain metastasis is critical for optimal treatment. Though rare, effective individualized therapy and further exploration of treatment plans are important to improve management for these patients.

Disclosures The authors have no conflicts of interest to declare.

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