Colon metastasis 20 years after the removal of ovarian cancer: Report of a case

Abstract

This report describes the case of a patient who had undergone surgery to resect bilateral ovarian tumors and then presented with colon metastasis 20 years later. A 69-year-old woman was admitted to the hospital for a clinical survey. She had been operated on for bilateral ovarian cancer in 1987 and was treated by postoperative adjuvant chemotherapy. The patient's follow-up showed no abnormality until 2006. Colonoscopy revealed an elevated irregular lesion in the cecum. A biopsy of the lesion showed a group V, moderately differentiated adenocarcinoma. A right hemicolectomy with a partial resection of the ileum and a lymphadenectomy was performed. Immunohistochemical staining during the pathological diagnosis showed the lesion to be colon metastasis from a serous papillary adenocarcinoma of the ovary. Immunohistochemical staining was positive for cytokeratin 7, carbohydrate antigen (CA)-125, and estrogen receptors, and negative for cytokeratin 20, carcinoembryonic antigen, and CA19-9. The use of immunohistochemistry demonstrated the tumor to be of ovarian origin.

An Incidental RectalWall Bulging Lesion in a Patient with a History of Resected Ovarian Tumor

“…Serous papillary ovarian carcinoma metastasis to the hypoechoic fourth layer of the gastric wall and the colonic wall as late hematogenous metastasis were presented as case reports. [4][5][6][7][8] The present case demonstrates the rectal wall metastasis of a well differentiated epithelial ovarian tumor resected more than a decade ago. Tumor dormancy represents an important mecha- nism underlying the failure of existing therapeutic modalities to fully eradicate cancers.…”

Solitary Colorectal Metastasis from a Mucin-rich Ovarian Tumor

“…Interestingly, our lesion was soft, probably due to the rich mucinous component. This seems to be the second reported case of solitary colorectal metastasis from ovarian tumors more than ten years after surgery in the English literature (1). Secondary surgery would be the most recommended treatment for resectable recurrent ovarian tumors (2).…”

Synchronous Ovarian Carcinoma with Colorectal Metastases: An Unusual Presentation

“…10 However, the problem exists in sorting out these tumors, including in cases mucinous adenocarcinomas, when there is simultaneous involvement of the ovary and the colorectum at similar (synchronous) or at different (metachronous) times. 2 Rekhi et al 12 showed that morphologically, metastatic tumor deposits in the colorectum retained the morphology of ovarian papillary serous cystadeocarcinoma with foci of psammomatous calcification in 6 of their 11 cases. Absence of garland-like tumor and necrosis were pointers towards an ovarian primary, apart from the clinical context of a preceding ovarian tumor in 81.8% such cases.…”

“…Tumor spread to more distant sites, including the contralateral ovary and bilateral ovarian cancers almost always represents a primary tumor and its metastasis rather than dual primary cancers. 2,3 The parallel evolution model suggests that cells with metastatic potential separate from the primary tumor at an early stage in development and evolve independently from the primary tumor. 1 …”