A case of ovarian metastasis from sigmoid colon cancer that caused intraperitoneal bleeding and required emergency surgery

Abstract

The present patient was a 42-year-old woman who developed abdominal bloating in late March 2007. She visited the Department of Gynecology, where she was suspected of having hysteromyoma or ovarian tumor, but was referred to the Department of Surgery for detailed examination of the digestive tract in early April. Sigmoid colon cancer was detected on lower gastrointestinal endoscopy. On the last day of April, the patient visited the emergency department of our hospital with a complaint of severe abdominal pain that had developed in the morning. Based on emergency CT and abdominal paracentesis, the patient was diagnosed with intraperitoneal bleeding caused by tumor rupture and was immediately hospitalized on the same day. Although anemia did not progress following hospitalization, the abdominal pain did not improve and the patient developed bilateral pleural effusion in addition to increased ascites. Due to the gradual deterioration of the patient's condition, emergency surgery was performed in early May. Laparotomy revealed 2 L of hemorrhagic ascites and peritoneal dissemination. Bilateral ovariectomy and Hartmann's procedure for sigmoid colon cancer were performed. Based on pathological examination, the patient was diagnosed with ovarian and disseminated nodules that had metastasized from sigmoid colon cancer.
Although ovarian metastasis from colon cancer has become more commonly reported in recent years, it rarely results in intraperitoneal bleeding. We describe the present patient with reference to literature.