A CASE OF OVARIAN METASTASIS FROM A RECTAL CANCER

Abstract

It is relatively uncommon that rectal cancer metastasizes to the ovary. This time we experienced a case of rectal cancer with bilateral ovarian cancer which were resected on an one-step approach.
A 42-year-old woman was seen at the hospital because of abdominal tumor and constipation. Abdominal echography revealed a large cystic tumor in the right ovary. As to tumor markers, CEA and CA 125 were as high as 1, 000ng/ml and 79U/ml respectively and a malignant tumor of the digestive system was suspected. Barium enema study revealed apple core sign in the rectum. Abdominal CT scan and MRI revealed a large cystic tumor in the right ovary. With a suspicion of metastatic ovarian tumor from rectal cancer or primary ovarian tumor, low anterior resection for the rectal cancer, bilateral oophorectomy and uterectomy were performed simultaneously. Postoperative course was uneventful. Histological grading of the rectal cancer was se, ly₁, v₁, n₁, P₂, H₀, and stage IV. Histological diagnosis of the resected specimen material of the rectum was well differentiated adenocarcinoma and not only the right ovary but also the left ovary had metastatic foci from the rectal cancer.
It is considered that bilateral oophorectomy should be performed when metastatic ovarian tumor of rectal cancer is diagnosed, because bilateral ovarian metastases can occur in a high rate.