Intrathecal Chemotherapy Through Ommaya Reservoir in Leptomeningeal Metastasis From Cervical Cancer: A Rare Case Report and Literature Review.

Leptomeningeal metastasis (LM) is a rare complication of cervical cancer associated with a poor prognosis. We report a 61-year-old woman with stage IVB cervical squamous cell carcinoma who developed acute headache and diplopia during systemic chemotherapy. Brain magnetic resonance imaging suggested LM, which was confirmed by cerebrospinal fluid (CSF) cytology. An Ommaya reservoir was inserted, and intrathecal methotrexate therapy was initiated. The patient showed rapid neurological improvement, normalization of CSF opening pressure, and sustained clearance of malignant cells on serial CSF cytology. Although systemic disease subsequently progressed, LM-related neurological symptoms remained well controlled. The patient survived for 8 months after LM diagnosis. This case highlights the importance of considering LM in cervical cancer patients with new neurological symptoms and suggests that intrathecal chemotherapy via an Ommaya reservoir may provide effective neurological control and symptomatic relief.