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319 Rare ovarian cancer presentation
  1. R Pedrini Cruz1,
  2. G Peretti Rodini1,
  3. M Duarte da Rosa1,
  4. V Duarte Cabral2 and
  5. E Cambruzzi2
  1. 1Hospital Nossa Senhora da Conceição, Oncogynecology, Porto Alegre, Brazil
  2. 2Hospital Nossa Senhora da Conceição, Pathology, Porto Alegre, Brazil


Objectives To report an intestinal lymphangitis carcinomatosa related to ovary cancer.

Methods The information has been obtained through review of medical records and review of the literature.

Results A 57-year-old virgin, deaf-mute patient with cognitive deficit was referred to our hospital with left ovary neoplasia. Abdominal CT showed a 3.5 cm diameter mixed lesion in the left ovary. CA-125 was 74.55. Videolaparoscopy showed lymphatic fluid in the abdominal cavity, lesions in epiploon compatible with metastatic implants. Left oophorectomy was performed. Frozen section revealed undifferentiated malignant neoplasia, not being able to rule out lymphoma. Pathology confirmed the hypothesis of high grade serous ovarian carcinoma. She was readmitted in 2 weeks later with clinical signs of high bowel obstruction. Abdominal CT demonstrated proximal jejunal obstruction. Exploratory laparotomy showed a thickened area of 10 cm in the proximal jejunum, with stenotic enteric lumen, with lesion apparently originating from its submucosal and muscular layers without implants in serosa. Proximal enterectomy, panhysterectomy, omentectomy, and resection of peritoneal implants in hepatic round ligament and bladder were performed. Pathology revealed jejunal stenosis due to an infiltrating tumor, lengthening 7.2 cm. Microscopy showed lymphatic tumoral emboli in mucosa, submucosa and muscularis propria. No serosal involvement was identified. Immunohistochemistry was compatible with metastatic high grade serous ovarian carcinoma.

Conclusions Our report demonstrates an unusual pattern of metastasis: embolization of intestinal lymphatic vessels, with subsequent stromal invasion. To the best of our knowledge, this is the first report in the literature of intestinal carcinomatous lymphangitis related to ovary cancer.

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