A Case of Ovarian Cancer Causing Solitary Anterior Mediastinal Metastasis after a Lapse of 43 Years following the Initial Treatment

Abstract

The case involved a 66-year-old woman who had been on the treatment for autoimmune hepatitis elsewhere as an outpatient. There was a previous history of undergoing left oophorectomy and right partial oophorectomy for an ovarian tumor at the age of 23. Furthermore, she underwent colectomy for a metastatic sigmoid colon tumor arisen from the ovarian cancer when 40 years had elapsed after the ovarian surgery. Thereafter, a follow-up chest CT scan disclosed a new nodular lesion at the anterior mediastinum, and then she was referred to our hospital. Since efficient methods for preoperative diagnosis were absent, we performed tumor excision with associated resection of the anterior chest wall to treat as well as to diagnose it. The histopathological diagnosis was the same ovarian cancer (serous carcinoma) as the previous sigmoid colon tumor. The patient received adjuvant chemotherapy and has been alive without having recurrence as of 10 years after the second operation.

This paper deals with a rare case of ovarian cancer which recurred to the sigmoid colon and the anterior mediastinum metachronously, solitarily and distantly after a lapse of more than 40 years following the initial operation, together with a literature review.