Challenging diagnosis of a jejunal adenocarcinoma with ovarian metastasis: report of an unusual case

We report the first documented case of ovarian metastasis from a jejunal primary adenocarcinoma in an Australian patient. The presentation was unusual, initially a suspicious abdominal nodule in the epigastric area, which turned out to be an adenocarcinoma of possible intestinal origin. Gastroscopy...

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Bibliographic Details
Published in:BMJ case reports 2013-04, Vol.2013, p.bcr2013008842
Main Authors: Huang, Yang Yang, Pratt, Jeremy John, Dabner, Marcus, Tjhin, William
Format: Article
Language:English
Subjects:
Abdomen
Adenocarcinoma - secondary
Adenocarcinoma - surgery
Australasia
Biomarkers, Tumor - analysis
Chemotherapy
Diagnosis, Differential
Diagnostic Imaging
Family medical history
Fatal Outcome
Female
Histopathology
Humans
Jejunal Neoplasms - pathology
Jejunal Neoplasms - surgery
Metastasis
Middle Aged
Neoplasm Staging
Ostomy
Ovarian cancer
Ovarian Neoplasms - secondary
Ovarian Neoplasms - surgery
Palliative care
Rare Disease
Thyroid gland
Transcription factors
Tumors
White
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Summary:We report the first documented case of ovarian metastasis from a jejunal primary adenocarcinoma in an Australian patient. The presentation was unusual, initially a suspicious abdominal nodule in the epigastric area, which turned out to be an adenocarcinoma of possible intestinal origin. Gastroscopy and colonoscopy were performed with no suspicious lesion identified. Abdominal and pelvic ultrasound imaging showed a complex pelvic mass suspicious of ovarian cancer. Laparoscopy was performed to exclude possibility of ovarian cancer and small bowel cancer. The ovarian mass showed similar features from the epigastric nodule, again suggestive of intestinal primary. Definitive diagnosis was obtained when the patient represented 2 months later with malignant bowel obstruction requiring palliative resection of the proximal jejunum. This case demonstrates the difficulty in diagnosing ovarian metastasis from a small bowel primary, which has the potential to mimic an ovarian primary tumour clinically, and a large bowel or ovarian primary pathologically.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-008842