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A 68-year-old woman presented with a three-week history of confusion and anomic aphasia. Imaging of her head demonstrated a single large left frontal mass. Pathology revealed metastatic adenocarcinoma of Müllerian origin. Subsequent surgery revealed a small primary site in a fallopian tube, high left para-aortic lymphadenopathy, and no disseminated intraperitoneal disease. This case was remarkable in that CNS metastasis was her presenting symptom and was restricted to a solitary brain lesion, and other disease sites were limited to retroperitoneal lymphadenopathy and a small fallopian tube primary.

Objective To quantify the impact of perioperative β blocker use on survival after primary cytoreductive surgery for epithelial ovarian cancer. Methods We conducted a multi-center retrospective study of all women who underwent primary cytoreductive surgery for ovarian cancer (2000 − 2010). One institution had routinely used perioperative β blockers for patients “at risk” for coronary events. The other institution did not routinely use perioperative β blockers. Demographic, operative, and follow up data were collected. Cox proportional hazards models were used to assess the effect of β blockers on progression-free interval (PFI) as well as overall survival (OS). Results Out of 185 eligible patients, 70 received β blockers and 115 underwent cytoreductive surgery without perioperative β blockers. Both groups were similar in demographics. A history of hypertension was present more often in the β blocker group compared to the group that did not receive β blockers (22% and 6%, p = 0.002). PFI in β blocker group was greater at 18.2 vs. 15.8 months (p = 0.66). The OS in the β blocker group was significantly higher at 44.2 vs. 39.3 months (p = 0.01). In multivariate analysis, perioperative β blocker use was associated with significant improvement in OS (HR 0.68 (0.46–0.99); p = 0.046). Conclusion Our study showed an association between perioperative β blocker use and longer overall survival in patients undergoing primary ovarian cancer cytoreductive surgery. A prospective randomized clinical trial in this population would further validate these results.