Abstract. Transitional cell carcinoma (TCC) of the ovary is a rare subtype of epithelial ovarian cancer. The present study reports the case of a 55-year-old patient from The Affiliated Tumor Hospital of Harbin Medical University (Harbin, Heilongjiang, China) who underwent successful surgery for recurrence of a TCC of the ovary with rectum metastases following the initial surgery and chemotherapy. Positron emission tomography/computed tomography (PET-CT) was used in the pre-operative detection of the tumor and the post-operative follow-up of the patient. To date, the patient has experienced 8 years of disease-free survival. The aim of the present study was to convey the good survival rate of the patient following recurrent TCC of the ovary, and the role of PET-CT in detection and follow-up, in order to aid in the future selection of appropriate diagnostic methods and therapies for this disease.
IntroductionTransitional cell carcinoma (TCC) of the ovary, in contrast to that of the bladder, is a rare entity and therefore, studies of recurrence are few in number. The true incidence of TCC of the ovary remains unclear. TCCs represent a small percentage of ovarian cancers, and have been demonstrated to be a distinct group, with differing histological and immunohistological aspects. However, the clinical presentation of TCC is similar to that of other types of ovarian carcinoma (1). Its typical symptoms include abdominal pain, abdominal distension and pelvic masses, and serum CA-125 is usually positive. The primary therapeutic approach for TCC is surgery and chemotherapy, and the consequent patient outcomes are an improvement on those of other types of common epithelial ovarian cancers (2).
Case reportIn 2004, a 55-year-old female was diagnosed with International Federation of Gynecology and Obstetrics stage IIIc (3) TCC of the ovary in the Department of Gynecology in The Affiliated First Hospital of Harbin Medical University (Harbin, Heilongjiang, China) and underwent satisfactory cytoreductive surgery consisting of hysterectomy, bilateral salpingo-oophorectomy, appendectomy and partial omentectomy. The post-surgical pathological evaluation revealed that the the ovarian tumor was TCC, grade 3, with involvement of the appendix. Subsequently, seven cycles of chemotherapy were administered, consisting of paclitaxel (175 mg/m 2 ; intravenously over 3 h) followed by carboplatin [area under the curve (AUC), 5-7.5 mg/ml/min; intravenously over 1 h] on day 1 of a three-week cycle, and a complete clinical response was achieved. Thereafter, the patient was followed up without any further treatment. Nearly two years after the initial therapy, the patient returned to hospital due to a two-month history of shapeless stool. The patient's cancer antigen (CA)-125 levels were within the normal range (normal range, <35 U/ml), and positron emission tomography-computed tomography (PET-CT) detected metastases of the rectum, with no other positive sites (Fig. 1). Review of the initial histopathology using immunohistochemistry revealed a gr...