Manifestation of Bilateral Huge Ovarian Metastases from Colon Cancer Immediately After the Initial Operation: Report of a Case

Abstract

This report describes the case of a 34-year-old premenopausal woman in whom bilateral huge ovarian metastases were found immediately after initial surgery for sigmoid colon cancer. Both ovaries had been intact at the time of sigmoidectomy, but 2 months later, she complained of persistent vaginal bleeding, and large bilateral metastases were detected in both ovaries. Oophorectomy with intraperitoneal chemotherapy proved ineffective and the patient died 3 months later, after a second operation, from peritoneal dissemination. This case report serves to demonstrate the importance of searching for synchronous or nonsynchronous metastases to the ovaries after surgery for colon cancer in young women. Consideration should also be given to the feasibility of performing prophylactic oophorectomy or administering intensive chemotherapy in association with colon resections for carcinoma for premenopausal women because of the ineffectiveness of these modalities as treatment for metastatic disease.

Ovarian metastasis from colorectal cancer: Prognostic value of radical oophorectomy

“…Similar good results were reported by Morrow et al and Ayan et al [17,18]. On the contrary in some other series the median survival was remarkably lower [2,7,11,12,18]. The substantial difference among these studies may be due to the different selection of the patients: in our study only patients with isolated ovarian metastasis were included whereas Wright et al included also debulking palliated patients without distinguish their outcome [19].…”

“…In our series isolated ovarian metastases from primary colorectal cancer occurred in less than 3% of female patients undergoing colorectal resection and this low frequency, compared to data in literature [7,11], might be influenced by the strict inclusion criteria adopted in this analysis. The rarity of this metastasis in its isolated form is the cause of the small sample size of our study group.…”

“…Ovary is a site of metastasis for many cancers, and the colorectal cancer is the most common primary cancer [5,6]. In fact, 2% of the patients with primary colorectal cancer are reported to develop metachronous ovarian metastases within 2 years from primary resection [7]. The incidence of ovarian metastases from gastrointestinal tumors seems to be higher in young menstruating women [3,5].…”

659: Somatic mutation profiles in primary colorectal cancers and matching ovarian metastases: Identification of driver and passenger mutations

“…Variants were functionally annotated using ANNO-VAR [23,24]. We then selected variants more likely to have a deleterious effect.…”

“…In cases of ovarian metastasis of CRC, dissemination through the lymphvascular system or through direct peritoneal spreading are considered to be the first steps [24]. Next, circulating tumour cells in lymph or blood vessels require homing signals to settle at distant sites.…”