Giant metastatic ovarian tumor originating from the colon in 61-year-old female – Case report
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Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Poland
Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Voivodeship Polyclinical Hospital in Olsztyn, Poland
Submission date: 2013-03-02
Acceptance date: 2013-07-08
Online publication date: 2013-07-09
Publication date: 2020-04-07
Corresponding author
Leszek Frąckowiak   

Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland. Tel.: +48 601 611 435.
Pol. Ann. Med. 2013;20(1):39-42
Ovary is a common site of primary tumors and metastases. Metastases consist approximately 20% of ovarian cancers. Clinical symptoms of metastases may imitate symptoms of primary ovarian cancer. Metastatic tumors to the ovary in about 50%–80% of cases are bilateral. The 5-year survival rate is in the range of 10%–24%. It is rare not to localize the primary site.

A case of giant metastatic ovarian tumor of unknown primary site in 61-year-old multipara was presented.

Material and methods:
The case was presented on the basis of medical record of the patient.

Case study:
A female with an abdominal mass was admitted to the Department of Gynecology for a surgical removal of the tumor. The patient complained of abdominal distension. She was qualified for a surgical procedure. During surgery a 24-cm tumor of the left ovary was resected. The intraoperative pathologic examination identified cystadenocarcinoma mucinosum. Surgical resection was extended and hysterectomy with right salpingo-oophorectomy and pelvic lymphadenectomy was performed. The pathologic examination reported that the tumor was compatible with Adenocarcinoma metastaticum et intestino crasso. Diagnostic imaging and endoscopy did not reveal a primary site. Two years after the surgery the patient feels well.

Results and discussion:
In pathologic examination there was a difficulty in determining the primary site. Final diagnosis was made based on immunohistochemical results. Immunohistochemical profile: CK7(–), CA125(–), CK20(+++), CDX2 (+++), Mucicarmine(7), is characteristic of colorectal cancer. Metastatic ovarian tumors require extended diagnostic imaging and histopathology.

In preoperative diagnosis of ovarian tumors possibility of metastases should be taken into account. Diagnostic difficulties require close collaboration between the clinician and the pathologist at each stage of cancer diagnosis.

None declared.
Dionigi A, Facco C, Tibiletti MG, Bernasconi B, Riva C, Capella C. Ovarian metastases from colorectal carcinoma. Clinicopathologic profile, immunophenotype, and karyotype analysis. Am J Clin Pathol. 2000;114(1):111–122.
Eveno C, Goéré D, Dartigues P, Honoré C, Dumont F, Tzanis D, et al. Ovarian metastasis is associated with retroperitoneal lymph node relapses in women treated for colorectal peritoneal carcinomatosis. Ann Surg Oncol. 2013;20(2):491–496.
Garrett CR, George B, Viswanathan C, Bhadkamkar NA, Wen S, Baladandayuthapani V, et al. Survival benefit associated with surgical salpingo-oophorectomy in patients with colorectal cancer metastatic to the ovary. Clin Colorectal Cancer. 2012;11(3):191–194.
Gurbuz A, Kir G, Karateke A, Haliloglu B, Kabaca C. Metastatic ovarian carcinoma one year after surgical removal of colon carcinoma during pregnancy: a case report. Int J Gynecol Cancer. 2006;16(suppl 1):330–333.
Ishii M, Ishibashi K, Ishiguro T, Kuwabara K, Ohsawa T, Okada N, et al. Analysis of ovarian metastasis of colorectal cancer – a comparison between ovarian metastasis and peritoneal metastasis without involving ovaries. Gan To Kagaku Ryoho. 2009;36(12):2257–2259 [in Japanese].
Kim DD, Park IJ, Kim HC, Yu CS, Kim JC. Ovarian metastases from colorectal cancer: a clinicopathological analysis of 103 patients. Colorectal Dis. 2009;11(1):32–38.
Omranipour R, Abasahl A. Ovarian metastases in colorectal cancer. Int J Gynecol Cancer. 2009;19(9):1524–1528.
Porjazova E, Zaprjanov Z, Batashki I, Markova D, Milchev N. Immunohistochemical profile of colorectal and ovarian carcinomas – examination with cytokeratin 7, cytokeratin 20, beta catenin and cDX 2. Akush Ginekol (Sofiia). 2009;48(2):7–12 [in Bulgarian].
Segelman J, Flöter-Rådestad A, Hellborg H, Sjövall A, Martling A. Epidemiology and prognosis of ovarian metastases in colorectal cancer. Br J Surg. 2010;97(11):1704–1709.
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