Giant metastatic ovarian tumor originating from the colon in 61-year-old female – Case report

• Published in: Polish annals of medicine 2013-09, Vol.20 (1), p.39-42
• Main Authors: Frąckowiak, Leszek, Wroński, Konrad, Kozielec, Zygmunt
• Format: Article
• Language: English
• Subjects: Colorectal cancer; Immunohistochemical tests; Metastases; Ovarian cancer; Ovarian tumor
• ISSN: 1230-8013
• DOI: 10.1016/j.poamed.2013.07.002

Ovary is a common site of primary tumors and metastases. Metastases consist approximately 20% of ovarian cancers. Clinical symptoms of metastases may imitate symptoms of primary ovarian cancer. Metastatic tumors to the ovary in about 50%–80% of cases are bilateral. The 5-year survival rate is in the range of 10%–24%. It is rare not to localize the primary site. A case of giant metastatic ovarian tumor of unknown primary site in 61-year-old multipara was presented. The case was presented on the basis of medical record of the patient. A female with an abdominal mass was admitted to the Department of Gynecology for a surgical removal of the tumor. The patient complained of abdominal distension. She was qualified for a surgical procedure. During surgery a 24-cm tumor of the left ovary was resected. The intraoperative pathologic examination identified cystadenocarcinoma mucinosum. Surgical resection was extended and hysterectomy with right salpingo-oophorectomy and pelvic lymphadenectomy was performed. The pathologic examination reported that the tumor was compatible with Adenocarcinoma metastaticum et intestino crasso. Diagnostic imaging and endoscopy did not reveal a primary site. Two years after the surgery the patient feels well. In pathologic examination there was a difficulty in determining the primary site. Final diagnosis was made based on immunohistochemical results. Immunohistochemical profile: CK7(–), CA125(–), CK20(+++), CDX2 (+++), Mucicarmine(±), is characteristic of colorectal cancer. Metastatic ovarian tumors require extended diagnostic imaging and histopathology. In preoperative diagnosis of ovarian tumors possibility of metastases should be taken into account. Diagnostic difficulties require close collaboration between the clinician and the pathologist at each stage of cancer diagnosis.