What happened, in summary

A 33-year-old woman had been treated for Stage III ovarian cancer with surgery and systemic chemotherapy 10 years earlier. During a screening scan, doctors found a calcified cyst-like lesion in the right cerebellum. Because she had no symptoms and preferred not to treat the presumed brain tumor, it was followed with repeat imaging.

Over the next 2 years, the lesion slowly enlarged. She eventually developed headache and positional vertigo, and imaging showed that the growing mass was blocking normal fluid flow in the brain and causing hydrocephalus. Surgeons removed the cerebellar tumor completely. Pathology showed adenocarcinoma consistent with spread from her ovarian cancer.

Her headache and vertigo improved after surgery, and follow-up imaging showed relief of the pressure and hydrocephalus. She was discharged 2 days later and then received whole-brain radiation. The brain metastasis represented Stage IV disease. The case highlights a very late, unusually slow-growing brain metastasis that initially looked more like a benign calcified brain tumor than recurrent ovarian cancer.