Surgical resection for small bowel obstruction due to right ovarian metastasis after ileocecal resection for cecal cancer: A case report

Although oophorectomy for ovarian metastasis from colorectal cancer is encouraged to improve the prognosis, that is also performed to relieve the symptom such as abdominal distention. We report a surgical case of intestinal obstruction due to ovarian metastasis after ileocecal resection for cecal cancer diagnosed at 77 years old.

PERITONEAL CARCINOMATOSIS SECONDARY TO OVARIAN CANCER: IMAGING FINDINGS

Summary: Peritoneal lesions are a relatively common site of metastases, particularly from tumors of the abdomen and pelvis, which generally carry a poor prognosis, often with a signicant impact on treatment. One of the tumors implicated in peritoneal metastasis is ovarian cancer. Ovarian cancer is the fth most commonly diagnosed cancer among women worldwide and the second most common gynecologic malignancy. Despite clinical screening, ovarian cancer in more than 60% of those affected is diagnosed at an advanced stage with a reported 5-year survival rate of 37% (stage III disease) or 25% (stage III disease). IV). Therefore, ovarian cancer is one of the deadliest cancers affecting women. Ovarian tumors are classied according to the origin of the tumor into epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner's tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, carcinoma embryonic), sex cord - stromal tumors (brothecoma; granulosa cell, sclerosing stroma and Sertoli-Leydig cell tumors) and metastatic tumors. Metastases to the ovary are relatively common with a documented incidence of 5% to 30% of all malignant ovarian masses. Ovarian cancer metastases differ from other tumors: they are primarily peritoneal rather than parenchymal in location. These implants are usually isodense in tomography, in relation to the viscera, which makes their detection difcult. For this, a multidisciplinary approach is used, such as physical examination, tumor marker levels and diagnostic images. Such as CT, magnetic resonance imaging (MRI) and positron emission tomography (PET). Objective: Describes ovarian metastasis in a patient with no signicant history, emphasizing peritoneal lesions, through a clinical case. Design: Prospective, observational in a single center. Methodology: This is a systematic review of ovarian metastasis, detailing its clinical characteristics and short-term complications. The information and images obtained belong to the medical personnel in charge of the case, whose reinforcements are provided by the Excel, Word and JPG statistical package.

Dificuldades no diagnóstico do câncer colorretal com metástase de ovário: uma revisão da literatura

O processo pelo qual o câncer colorretal (CCR) metastatiza para o ovário permanece obscuro. Porém, considera-se que, como não há fluxo linfático entre o cólon e os ovários, tanto as metástases hematogênicas quanto as peritoneais disseminadas apresentam possíveis vias metastáticas. O presente estudo tem como objetivo descrever as dificuldades e como é feito a realização do diagnóstico do câncer colorretal com metástase de ovário. Realizado através da Biblioteca Virtual de Saúde (BVS) nas bases de dados do Pubmed e Medline, usando os cruzamentos dos descritores em inglês “Colorectal cancer”,“Ovarian metastasis”, “Diagnosis”. Para a avaliação do problema de pesquisa e sua estratificação foi utilizada a estratégia PVO sendo formulada a seguinte estratégia que pode ser observada no Quadro 1. A estratégia supracitada permitiu formular a seguinte questão norteadora: “Como é realizado o diagnóstico do câncer colorretal com metástase de ovário?”. O diagnóstico diferencial entre tumores primários e metástases ovarianas costuma ser difícil. Os sintomas associados ao desenvolvimento de câncer ovariano podem mascarar a doença intestinal. Os valores séricos dos marcadores tumorais do antígeno de carboidrato (CA-125) e antígeno carcinoembrionário (CEA) tem um papel importante para a diferenciação entre pacientes com CCR primário com metástase ovariana. Embora difícil, o diagnóstico diferencial deve ser feito precocemente para minimizar as complicações. As alternativas diagnósticas incluem avaliação histopatológica com a identificação de subtipos histológicos metastáticos semelhantes aos subtipos de câncer colorretal primário, sendo os adenocarcinomas mucinosos mais comuns.

Estimating the risk of malignancy of adnexal masses: validation of the ADNEX model in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China

Background This study aims to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) the Assessment of Different NEoplasias in the adneXa (ADNEX) model in the preoperative diagnosis of adnexal masses in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China. Methods This was a single oncology centre, retrospective diagnostic accuracy study of 620 patients. All patients underwent surgery, and the histopathological diagnosis was used as a reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumours, borderline ovarian tumours (BOTs), stage I ovarian cancer (OC), stage II-IV OC and ovarian metastasis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumours into different histological types with and without cancer antigen 125 (CA 125) results. Results Of the 620 women, 402 (64.8%) had a benign ovarian tumour and 218 (35.2%) had a malignant ovarian tumour, including 86 (13.9%) with BOT, 75 (12.1%) with stage I OC, 53 (8.5%) with stage II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign and stage II-IV OC and between benign and ovarian metastasis, with AUCs of 0.99 (95% CI, 0.99–1.00) and 0.99 (95% CI, 0.98–1.00), respectively. The model was less effective at distinguishing between BOT and stage I OC and between BOT and ovarian metastasis, with AUCs of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, the performance in discriminating between stage II–IV OC and stage I OC and between stage II–IV OC ovarian metastasis was improved (AUC increased from 0.88 to 0.94, P = 0.01, and from 0.86 to 0.97, p = 0.01). Conclusions The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of nonexpert ultrasonographers with limited experience in China. In classifying different subtypes of ovarian cancers, the model has difficulty differentiating BOTs from stage I OC and BOTs from ovarian metastases.

Case Report: Gastric Cancer Combined With Bilateral Ovarian Metastasis In Pregnancy

Background: The early manifestations of gastric cancer during pregnancy are non-specific. Ovarian mass and ascites are the main manifestations of late ovarian metastasis. Case presentation: A case of late gastric cancer with bilateral ovarian metastasis in pregnancy was reported in our study. Cesarean section and full staging of ovarian malignant tumors were performed at 28+5 weeks of pregnancy, and the prognosis was poor. We performed Cesarean delivery and extracted a vital male newborn of 35 cm, 1020 g, Ap score 3. The newborn is alive and grows normally. Three months later the mother died. The key to improving the prognosis is early diagnosis, and the pre-pregnancy health checkup must be emphasized. Conclusions: During pregnancy, ultrasound, gastroscopy, MRI and other related examinations should be performed to confirm the diagnosis, and individualized treatment plans should be formulated to maximize the protection of the mother and child's interests.