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Peer-reviewedCC BY 4.0Frontiers in Oncology

10-year follow-up of a patient with high-grade serous ovarian carcinoma and concomitant Henoch-Schönlein purpura nephritis, with metachronous liver and brain metastases: a case report

5 affiliations
  1. 1School of Nursing, Anhui Medical University
  2. 2Department of Integrated Traditional Chinese and Western Medicine Oncology, The First Affiliated Hospital of Anhui Medical University
  3. 3Department of Pathology, The Affiliated Hospital of Xuzhou Medical University
  4. 4Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University
  5. 5Department of Medical Oncology, The Second Affiliated Hospital of Anhui Medical University

Abstract

Background: Brain metastasis from high-grade serous ovarian carcinoma (HGSOC) is rare, and serum Carbohydrate Antigen 125 (CA125) monitoring has limited surveillance value in this setting. Clinical evidence guiding the diagnosis and management of patients with such rare clinical presentations and comorbidities remains limited.

Case presentation: We report a patient with HGSOC (FIGO stage IIIB) who was followed for 10 years, from the initial diagnosis in 2016 to the latest follow-up in October 2026. She was clinically diagnosed with Henoch-Schönlein purpura nephritis (HSPN), complicated by synchronous HGSOC. She underwent cytoreductive surgery followed by docetaxel plus carboplatin (TC) chemotherapy. In 2018, HSPN recurred concurrently with surgical-site recurrence and hepatic metastasis. Following chemotherapy, HSPN remitted without specific immunosuppressive treatment, while the hepatic lesions achieved near-complete remission. In 2021, she developed a solitary left occipital brain metastasis, and her clinical symptoms improved after surgical resection, whole-brain radiotherapy and chemotherapy. Intracranial tumor recurrence was confirmed in 2022. Genetic testing in 2023 identified a pathogenic germline mutation in breast cancer susceptibility gene 1 ( BRCA1 ), with positive homologous recombination deficiency (HRD) status. She subsequently received pamiparib-based therapy, including combination treatment with bevacizumab. At the latest follow-up, she remained neurologically asymptomatic with an ECOG performance status of 1.

Conclusions: This case demonstrates a temporal association between HSPN activity and the clinical course of HGSOC, raising the possibility of a tumor-associated immune phenomenon. In addition, prolonged disease control was observed during treatment with pamiparib plus bevacizumab in this patient with HGSOC brain metastasis harboring a pathogenic germline BRCA1 mutation and HRD positivity.

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BibTeX
@article{wang202610year,
  title = {{10-year follow-up of a patient with high-grade serous ovarian carcinoma and concomitant Henoch-Schönlein purpura nephritis, with metachronous liver and brain metastases: a case report}},
  author = {Di Wang and Lu Wang and Zhifa Zhu and Lei Xia and Bing Zhao and Wei Chen and Huan Qiu},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = nov,
  doi = {10.3389/fonc.2026.1869331},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1869331/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - 10-year follow-up of a patient with high-grade serous ovarian carcinoma and concomitant Henoch-Schönlein purpura nephritis, with metachronous liver and brain metastases: a case report
AU  - Di Wang
AU  - Lu Wang
AU  - Zhifa Zhu
AU  - Lei Xia
AU  - Bing Zhao
AU  - Wei Chen
AU  - Huan Qiu
PY  - 2026
DA  - 2026/11/09
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1869331
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1869331/full
AB  - Background: Brain metastasis from high-grade serous ovarian carcinoma (HGSOC) is rare, and serum Carbohydrate Antigen 125 (CA125) monitoring has limited surveillance value in this setting. Clinical evidence guiding the diagnosis and management of patients with such rare clinical presentations and comorbidities remains limited.  Case presentation: We report a patient with HGSOC (FIGO stage IIIB) who was followed for 10 years, from the initial diagnosis in 2016 to the latest follow-up in October 2026. She was clinically diagnosed with Henoch-Schönlein purpura nephritis (HSPN), complicated by synchronous HGSOC. She underwent cytoreductive surgery followed by docetaxel plus carboplatin (TC) chemotherapy. In 2018, HSPN recurred concurrently with surgical-site recurrence and hepatic metastasis. Following chemotherapy, HSPN remitted without specific immunosuppressive treatment, while the hepatic lesions achieved near-complete remission. In 2021, she developed a solitary left occipital brain metastasis, and her clinical symptoms improved after surgical resection, whole-brain radiotherapy and chemotherapy. Intracranial tumor recurrence was confirmed in 2022. Genetic testing in 2023 identified a pathogenic germline mutation in breast cancer susceptibility gene 1 ( BRCA1 ), with positive homologous recombination deficiency (HRD) status. She subsequently received pamiparib-based therapy, including combination treatment with bevacizumab. At the latest follow-up, she remained neurologically asymptomatic with an ECOG performance status of 1.  Conclusions: This case demonstrates a temporal association between HSPN activity and the clinical course of HGSOC, raising the possibility of a tumor-associated immune phenomenon. In addition, prolonged disease control was observed during treatment with pamiparib plus bevacizumab in this patient with HGSOC brain metastasis harboring a pathogenic germline BRCA1 mutation and HRD positivity.
SN  - 2234-943X
ER  -