Long-term response to olaparib in BRCA1-related ovarian cancer with brain metastases

Abstract

A 51-year-old woman with an unremarkable personal and family medical history sought medical attention after noticing an abdominal mass, which was located mainly in the right iliac fossa. A gynecological ultrasound and a CT body scan showed a 22.3×11.5 cm pelvic mass dependent on both ovaries, with peritoneal implants, retroperitoneal lymph nodes, and ascites, without supra-diaphragmatic disease, associated with a serum CA125 level of 2634 kIU/L. The patient first underwent an exploratory laparoscopy, and later a complete cytoreduction was performed with hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy, pelvic and para-aortic lymphadenectomy, and resection of tumor implants and the transverse, descending, and sigmoid colon. The histopathological examination confirmed the diagnosis of International Federation of Gynecology and Obstetrics (FIGO) stage IIIC high-grade serous ovarian carcinoma (Figure 1). After primary cytoreduction, the patient received six cycles of carboplatin, area under the curve 6 mg/mL/min, and paclitaxel 175 mg/m2 every 3 weeks. At the end of the treatment no disease remained on the CT scan and the CA125 level was normal.