OVARIAN CANCER METASTASIS TO THE CECUM
Yakovleva A.V., Meshcheryakov A.I., Gurova N.Yu., Emelyanceva N.A.
Polyclinic № 3, Department of Presidential Affairs of the Russian Federation. Moscow, Russia.
О |
varian cancer ranks seventh in the structure of cancer among women in the world with a high mortality rate, which is largely due to diagnosis at late stages. Metastases of ovarian cancer to the colon by hematogenous dissemination are extremely rare. To date, only nine cases have been described in the literature. All previously published cases of hematogenous metastasis of ovarian cancer to the colon involved the left colon. Colonoscopy was used to initially detect these metastases.
Purpose. To present a case of recurrent ovarian cancer in the form of distant hematogenous metastasis to the cecum, in which CT-colonography was used for the first line of diagnosis.
Materials and methods. In 2018 a 39-year-old woman was diagnosed with high-grade serous adenocarcinoma of both ovaries with metastases to the greater omentum and mesentery of the colon, mesentery of the appendix T3cN0M0, stage FIGO IIIC. The treatment was: non-adjuvant chemotherapy, cytoreductive surgery, adjuvant chemotherapy. A disease-free course was observed for 4 years. In 2022 a progression was detected with hematogenous metastasis in the cecum, carcinomatosis in the left subphrenic space and along the anterior surface of the rectum. A combined cytoreductive right hemicolectomy with anterior resection of the rectum, partial peritonectomy, resection of the diaphragm, adjuvant chemotherapy, and hormonal therapy was performed.
Results. Thickening of the cecal wall was suspected on routine contrast-enhanced computed tomography. CT-colonography was performed due to incomplete endoscopic colonoscopy, since the patient had adhesions in the pelvic cavity.
Discussion. Our study demonstrates a rare case of hematogenous metastasis of ovarian cancer to the cecum, which appeared after 4 years of disease-free progression in the patient after complete surgical cytoreduction and chemotherapy. Despite the presence of foci of peritoneal carcinomatosis at the time of surgery, the absence of exit of the cecal tumor onto the serous membrane of the cecum highly likely indicates a hematogenous route of metastasis, and not due to dissemination through the peritoneum with subsequent ingrowth into the intestinal wall.
Conclusion. This clinical case demonstrates the possibility of hematogenous spread of ovarian cancer to the colon, which must be taken into account for the timely diagnosis of progression. In addition, this case demonstrated the feasibility of CT-colonography to diagnose colon metastases in case of incomplete colonoscopy.
Keywords: ovarian cancer, metastasis of ovarian cancer to the colon, CT-colonography.
Corresponding author: Meshcheryakov A.I., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Yakovleva A.V., Meshcheryakov A.I., Gurova N.Yu., Emelyanceva N.A. Ovarian cancer metastasis to the cecum. REJR 2024; 14(4):225-233. DOI: 10.21569/2222-7415-2024-14-4-225-233.
Received: 21.04.24 Accepted: 10.10.24