A case of synchronous serous ovarian cancer and uterine serous endometrial intraepithelial carcinoma
| Autor: | Keiichi Washio, Satoshi Nagamata, Masako Tomimoto, Maho Shimizu, Yuka Murata, Yui Yamasaki, Maho Azumi, Keitaro Yamanaka, Ryosuke Takahashi, Yoshito Terai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Serous Endometrial Intraepithelial Carcinoma
medicine.medical_specialty endocrine system diseases Serous carcinoma Ovary Case Report SEIC Uterine serous carcinoma Neoplasms Multiple Primary Ovarian tumor Paraaortic lymph nodes Ovarian carcinoma medicine Humans Ultrasonography Ovarian Neoplasms business.industry Obstetrics and Gynecology Gynecology and obstetrics Middle Aged medicine.disease Serous endometrial intraepithelial carcinoma Magnetic Resonance Imaging female genital diseases and pregnancy complications Endometrial Neoplasms Postmenopause Serous fluid medicine.anatomical_structure Oncology Lymphatic Metastasis RG1-991 Serous ovarian cancer Female Radiology business Carcinoma in Situ |
| Zdroj: | Journal of Ovarian Research Journal of Ovarian Research, Vol 14, Iss 1, Pp 1-5 (2021) |
| ISSN: | 1757-2215 |
| Popis: | Background Serous endometrial intraepithelial carcinoma (SEIC) is now considered to represent an early stage of uterine serous carcinoma (USC). It is an intraepithelial lesion but has been reported to cause extrauterine metastases. We report a case of SEIC with serous ovarian carcinoma and lymph node metastasis. Case presentation A 57-year-old post-menopausal woman (gravida 3, para 2, SA1) was referred to our hospital with lower abdominal pain. An ultrasound and MRI showed that the ovary had swollen to 8 cm in size and had a solid lesion. The uterus was normal. The patient underwent exploratory laparoscopy on the suspicion of torsion of the ovarian tumor. Intraoperative findings showed a right ovarian tumor, but no ovarian tumor torsion was observed. A small amount of bloody ascites was found in the Douglas fossa, and bleeding was observed from the tumor itself. A right salpingo-oophorectomy was then performed. Histopathological results revealed a high-grade serous carcinoma. Forty days after the first surgery, we performed a staging laparotomy: a total abdominal hysterectomy, left salpingo-oophorectomy, systematic pelvic and paraaortic lymphadenectomy, and a partial omentectomy. A complete cytoreduction was achieved. In the pathological examination, the invasion of the serous carcinoma was observed in the left ovarian ligament, and lymph node metastasis was found in the paraaortic lymph nodes. Atypical columnar cells formed irregular papillary lesions which had proliferated in the endometrium, and this was diagnosed as SEIC. The final diagnosis was serous ovarian cancer, FIGO stage IIIA1(ii), pT2bN1M0, with SEIC. Conclusion We report a case of SEIC with synchronous serous carcinoma of the adnexa uteri. Both were serous carcinomas and, thus, it was difficult to identify the primary lesion. The distinction between metastatic cancer and two independent primary tumors is important for an accurate diagnosis and tumor staging. Histological diagnostic criteria remain controversial, and further development of a method for differentiating between both diseases is required. |
| Databáze: | OpenAIRE |
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