Bilateral Metastatic Ovarian Carcinoma in a Case of Lung Adenocarcinoma

Abstract

The patient was a 59-year-old woman. In September 2006, a chest roentgenogram showed a nodule-like lesion in the right lung. A chest computed tomographic scan revealed a nodule in the right middle lobe (S4). She was admitted to our hospital for diagnosis of the nodule on a suspicion of lung cancer. Transbronchial lung biopsy was performed, and a diagnosis of adenocarcinoma was made (cT1N1M0, StageIIA). Then She underwent a surgical lobectomy (ND2a) in November 2006. Advanced non small cell lung cancer (pathological stage T4N2M0, StageIIIB) was then diagnosed. Carbopolatin plus gemcitabine was administered but was not effective. 18-fluorodeoxyglucose positron emission tomography (PET) showed abnormal uptake in the multiple lung nodules and right supraclavicular lymph node. And then, gefitinib was administered after EGFR mutation (Exon 19 deletion) was found in the tumor specimen. 18-fluorodeoxyglucose PET showed abnormal uptake in the right supraclavicular lymph node and multiple lung metastases in the right pleura and pelvis, and then CT scan and MRI revealed in the bilateral ovarian metastasis in May 2009. Systemic anticancer chemotherapy consisting of amrubicin, pemetrexed and erlotinib did not have any effect and she died. Ovarian metastasis was identified on autopsy. Ovarian metastasis from lung cancer is rare. We report a case with a brief review of the literature.