Abstract
A 54-year-old woman consulted our hospital for a chief complaint of abdominal distension. Colonoscopic examination revealed advanced sigmoid colon cancer without intestinal obstruction. A few days later, the patient was urgently hospitalized in the emergency department because the symptoms worsened. An abdominal CT scan showed a multilocular cystic tumor, of 10 cm in diameter and abundant ascites. The cytodiagnosis of ascites was class II and further examination was scheduled for the suspicion of left ovarian cancer. However, emergency surgery was performed due to sudden abdominal pain and severe ascites. Laparotomy showed thick hemorrhagic ascitic fluid and bleeding from the rupture of the left ovarian mass. Because quick cytological examination of ascitic fluid showed adenocarcinoma cells, we diagnosed rupture of metastatic ovarian tumor from sigmoid colon cancer. High anterior resection and left oophorectomy were performed. Postoperative pathological examination and immunohistochemistry findings confirmed that the ovarian tumor had metastasized from sigmoid colon cancer. The patient received postoperative adjuvant chemotherapy. To date, no sign of recurrence has been observed 4 years after surgery.
