A Case of Ascending Colon Metastasis of Ovarian Cancer with Mesocolic Lymph Node Metastases

Abstract

A 59-year-old woman with a history of simple total hysterectomy, bilateral adnexectomy, and disseminated nodule resection for stage IIIC ovarian cancer (high-grade serous adenocarcinoma) received postoperative chemotherapy. Approximately 2 years after the operation, CA125 level was found to be elevated, and a PET-CT scan showed an accumulation in the ascending colon. A lower gastrointestinal endoscopy revealed a submucosal tumor-like protrusion in the ascending colon. A peritoneal nodule near the ascending colon was resected by laparoscopy, but the results were negative. A diagnosis of ascending colon metastasis from ovarian cancer was made, and a robot-assisted ileocecal resection and D3 dissection were performed. Histopathological assessment revealed cells that closely resembled the previous ovarian cancer. Additionally, three metastatic lesions were found in regional lymph nodes. Metastasis of ovarian cancer to the ascending colon is relatively rare in Japan; therefore, we report this case with a literature review.