Abstract
We have experienced a case of metachronous metastasis to the ovary from rectal cancer associated with pseudo-Meigs syndrome.
A 53-year-old woman was seen at the hospital because of abdominal distension, weight gain and appetite loss while she had been treated with chemotherapy for recurrent rectal cancer. She had pleural effusion, ascites and an intrapelvic tumor, and serum levels of CEA, CA19-9, and CA125 were high. Pseudo-Meigs syndrome due to an ovarian tumor was the most likely diagnosis. Her general condition gradually deteriorated due to respiratory dysfunction so that right salpingo oophorectomy was performed to improve short-term prognosis. Histological studies showed cytokeratin 7 negative and cytokeratin 20 positive and then we diagnosed the case as pseudo-Meigs syndrome due to metachronous ovarian metastasis of rectal cancer. After the operation, pleural effusion and ascites disappeared and no re-retention occurred. Chemotherapy was thus resumed, however, her general condition was taking downhill course and she died of primary malignancy 4 months after the operation.
Metachronous ovarian metastasis of colorectal cancer carries poor prognosis. However, in the treatment of a colorectal cancer patient with pseudo-Meigs syndrome, we must be aware of the usefulness of oophorectomy for improvement of the poor prognosis due to respiratory failure.
