A case of rapidly growing ovarian cancer manifesting as positive uterine cytology alone, in which it was difficult to diagnose the tumor origin

Abstract

Background : We report a case of rapidly growing ovarian cancer manifesting as positive uterine cytology alone, in which it was difficult to diagnose the tumor origin.
Case : The patient was a 49-year-old female with positive uterine endometrial cytology. CT and MRI showed no evidence of any tumor in the uterus or within the abdominal cavity. One month later, surgical operation was performed under the diagnosis of small uterine endometrial cancer or small ovarian cancer, however, intraoperative findings showed massive metastasis in the abdominal cavity. The pathological diagnosis was bilateral ovarian cancer, stage IIIc, with right Tubal Intraepithelial Carcinoma.
Conclusion : Ovarian high-grade serous adenocarcinoma with TIC may progress rapidly, with rapid spread of the tumor cells in the abdomen. Early detection of ovarian cancer is still a challenge, however, careful investigation of the uterine cytology could suggest the origin of mullerian malignancies and enable a decision on the appropriate surgical procedure.