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Following completion of neoadjuvant chemotherapy, interval debulking surgery and adjuvant chemotherapy, relapsed disease was ultimately identified as a single BM, curiously mimicking an acoustic neuroma. Subsequently, spinal cord metastases rapidly developed. Throughout, multidisciplinary team meetings guided decisions on patient management. In this report, we highlight the rarity of such a presentation and discuss the possible role of disease pathophysiology, associated systemic anticancer therapy resistance, and treatment possibilities for both cerebral and spinal metastases.<\/jats:p>","DOI":"10.1136\/bcr-2023-259144","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T22:45:23Z","timestamp":1716331523000},"page":"e259144","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Synchronous skull base and spinal metastases in a patient with treatment-resistant, high-grade serous adenocarcinoma of tubo-ovarian origin"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2944-7877","authenticated-orcid":false,"given":"Joseph","family":"Ziegler","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim Hussien","family":"El-Shakankery","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harpreet","family":"Hyare","sequence":"additional","affiliation":[{"name":"Imaging Department, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Clinical Research Facility, NIHR University College London Hospitals Biomedical Research Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"2025082712493681000_17.5.e259144.1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz062"},{"key":"2025082712493681000_17.5.e259144.2","unstructured":"National Cancer Institute surveillance E and ERP . 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