Introduction/Background The most common nongenital malignancies that metastasize to the ovary include gastrointestinal cancers and breast cancer. We report a case of an ovarian tumor metastatic from a primary colon carcinoma and we review the data from the literature.
Methodology A woman of 79 years old was referred to our department due to an ovarian tumor found at an abdominal ultrasound. From the medical history of the patient there were complaints of bleeding from the intestine. The complete evaluation, including ultrasonography, computed tomography scans, magnetic resonance imaging and colonoscopy with biopsies revealed an adenocarcinoma of the sigmoid colon and reconfirmed the ovarian tumor of diameter 5 cm app.
A laparotomy followed, during which total abdominal hysterectomy with bilateral salpingo-oophorectomy, sigmoidectomy and omentectomy were performed. The ovarian tumor was metastatic from the colonic cancer. The final diagnosis was mucinous adenocarcinoma of the large intestine T3N1aM1c.
Results The preoperative evaluation of any ovarian tumor suspect for malignancy should include assessment for metastatic disease from another primary cancer. Ovarian metastases (synchronous or metachronous) are found in 1% up to 14% of patients with colorectal cancer. From all the cases of metastatic neoplasms to the ovary, colon is the most frequent primary site (15–32%). They are more common in premenopausal than postmenopausal women. Other nongenital sites of primary tumors are breast (8–28%), gastric (6–22%) and appendix (2–20%).
The prognosis of the patients with colon cancer and ovarian metastases (especially if bilateral) is poor, but it seems that optimal surgical cytoreduction, compared to suboptimal, is associated to a better overall survival rate.
Conclusion The evaluation of an ovarian neoplasm should exclude metastasis from another primary carcinoma. Colon is the most frequent primary site of ovarian metastases. Surgical resection seems to have an important role in the management of these patients.
Disclosure Nothing to disclose.
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