Non‑synchronous bilateral metastatic ovarian cancer originating from small bowel adenocarcinoma with multidisciplinary treatment: A case report

He,Xingting; Chen,Shuang; Zhou,Yejiang; Teichmann,Alexander Tobias; Ding,Shugui; Fan,Juan; Xiao,Xiuli; Zhao,Dongmei; Cai,Liang; Jiang,Yifan; Deng,Xuemei; Yang,Hongru

doi:10.3892/ol.2023.14182

Non‑synchronous bilateral metastatic ovarian cancer originating from small bowel adenocarcinoma with multidisciplinary treatment: A case report

Authors:
- Xingting He
- Shuang Chen
- Yejiang Zhou
- Alexander Tobias Teichmann
- Shugui Ding
- Juan Fan
- Xiuli Xiao
- Dongmei Zhao
- Liang Cai
- Yifan Jiang
- Xuemei Deng
- Hongru Yang
View Affiliations

Affiliations: Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Gastrointestinal Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Sichuan Provincial Center for Gynecology and Breast Diseases (Gynecology), Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Nuclear Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
Published online on: December 8, 2023 https://doi.org/10.3892/ol.2023.14182
Article Number: 49
Copyright: © He et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Primary small bowel adenocarcinoma (SBA) is a rare gastrointestinal cancer with a low incidence of ovarian metastasis. Differential diagnosis of metastatic and primary ovarian cancer is often challenging. The present study reported the case of a 45‑year‑old woman with jejunal adenocarcinoma who presented with right ovarian, left ovarian, abdominopelvic implant and local recurrent bowel wall metastases successively after primary tumor resection. The ovarian masses of the patient originated from SBA, which was confirmed by immunohistochemical results. Following four comprehensive evaluations by an experienced multidisciplinary team (MDT) during the disease period, the patient underwent four operations, 28 cycles of chemotherapy, 24 cycles of targeted therapy and maintenance therapy for 8 months. As of February 2023, the patient has survived for 73 months and has a high quality of life. It is suggested that when a patient with SBA presents with an ovarian mass, the differential diagnosis between metastatic ovarian cancer and primary ovarian cancer mainly relies on immunohistochemistry. After a comprehensive evaluation by an experienced MDT, surgical resection is the primary treatment for advanced SBA, thus demonstrating some benefits for patients.

View Figures

View References

1	Aparicio T, Zaanan A, Svrcek M, Laurent-Puig P, Carrere N, Manfredi S, Locher C and Afchain P: Small bowel adenocarcinoma: Epidemiology, risk factors, diagnosis and treatment. Dig Liver Dis. 46:97–104. 2014. View Article : Google Scholar : PubMed/NCBI
2	Dabaja BS, Suki D, Pro B, Bonnen M and Ajani J: Adenocarcinoma of the small bowel: Presentation, prognostic factors, and outcome of 217 patients. Cancer. 101:518–526. 2004. View Article : Google Scholar : PubMed/NCBI
3	Halfdanarson TR, McWilliams RR, Donohue JH and Quevedo JF: A single-institution experience with 491 cases of small bowel adenocarcinoma. Am J Surg. 199:797–803. 2010. View Article : Google Scholar : PubMed/NCBI
4	Akce M, Jiang R, Zakka K, Wu C, Alese OB, Shaib WL, Behera M and El-Rayes BF: Clinical outcomes of small bowel adenocarcinoma. Clin Colorectal Cancer. 18:257–268. 2019. View Article : Google Scholar : PubMed/NCBI
5	Bruls J, Simons M, Overbeek LI, Bulten J, Massuger LF and Nagtegaal ID: A national population-based study provides insight in the origin of malignancies metastatic to the ovary. Virchows Arch. 467:79–86. 2015. View Article : Google Scholar : PubMed/NCBI
6	Rompteaux P, Gagnière J, Gornet JM, Coriat R, Baumgaertner I, Lecomte T, Afchain P, Zaanan A, Pocard M, Bachet JB, et al: Resection of small bowel adenocarcinoma metastases: Results of the ARCAD-NADEGE cohort study. Eur J Surg Oncol. 45:331–335. 2019. View Article : Google Scholar : PubMed/NCBI
7	Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, et al: AJCC cancer staging manual. 8th edition. Springer; New York: 2017, View Article : Google Scholar
8	Siegel RL, Miller KD, Fuchs HE and Jemal A: Cancer statistics, 2022. CA Cancer J Clin. 72:7–33. 2022. View Article : Google Scholar : PubMed/NCBI
9	Iijima K, Oozeki M, Ikeda K, Honda H, Ishibashi H, Yamaoka M, Fujieda S, Saitoh H, Goto M, Araki M and Amagai K: A case of small bowel adenocarcinoma wherein nivolumab conferred temporary benefit in disease control. Clin J Gastroenterol. 13:372–376. 2020. View Article : Google Scholar : PubMed/NCBI
10	An-Chieh Liu A, Chen CH, Liu WM and Chang CW: A rare Krukenberg tumor arising from a primary adenocarcinoma of the small intestine. Taiwan J Obstet Gynecol. 57:319–322. 2018. View Article : Google Scholar : PubMed/NCBI
11	Dunsmore KP and Lovell MA: Small bowel adenocarcinoma metastatic to the ovaries in 12-year-old girl. J Pediatr Hematol Oncol. 20:498–501. 1998. View Article : Google Scholar : PubMed/NCBI
12	Kilic G and Abadi M: Jejunal adenocarcinoma presenting as a primary ovarian carcinoma. Gynecol Oncol. 78:255–258. 2000. View Article : Google Scholar : PubMed/NCBI
13	Maekawa H, Sato K, Komatsu Y, Orita H and Sakurada M: Jejunal cancer detected after a resection of bilateral ovarian metastasis: Report of a case. Surg Today. 40:1084–1087. 2010. View Article : Google Scholar : PubMed/NCBI
14	Mitsushita J, Netsu S, Suzuki K, Nokubi M and Tanaka A: Metastatic ovarian tumors originating from a small bowel adenocarcinoma-a case report and brief literature review. Int J Gynecol Pathol. 36:253–260. 2017. View Article : Google Scholar : PubMed/NCBI
15	Tsuruchi N, Kubota H, Tsukamoto N and Kurano A: Primary jejunal adenocarcinoma masquerading as a primary ovarian malignancy. Gynecol Oncol. 58:129–132. 1995. View Article : Google Scholar : PubMed/NCBI
16	Iwata N, Shikama A, Takao W, Hosokawa Y, Itagaki H, Tasaka N, Akiyama A, Ochi H, Minaguchi T, Arita M, et al: Ovarian metastases from ileum cancer in a patient with germline EPCAM gene deletion successfully treated with surgical resection and CAPOX chemotherapy: A case report. BMC Med Genet. 21:762020. View Article : Google Scholar : PubMed/NCBI
17	Andresen DM, Pedersen FH and Rasmussen KL: Adenocarcinoma of the small intestine mistaken as a primary ovarian cancer. Arch Gynecol Obstet. 265:214–215. 2001. View Article : Google Scholar : PubMed/NCBI
18	Loke TKL, Lo SS and Chan CS: Case report: Krukenberg tumours arising from a primary duodenojejunal adenocarcinoma. Clin Radiol. 52:154–155. 1997. View Article : Google Scholar : PubMed/NCBI
19	Kir G, Gurbuz A, Karateke A and Kir M: Clinicopathologic and immunohistochemical profile of ovarian metastases from colorectal carcinoma. World J Gastrointest Surg. 2:109–116. 2010. View Article : Google Scholar : PubMed/NCBI
20	Benson AB, Venook AP, Al-Hawary MM, Arain MA, Chen YJ, Ciombor KK, Cohen SA, Cooper HS, Deming DA, Garrido-Laguna I, et al: Small bowel adenocarcinoma, version 1.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 17:1109–1133. 2019. View Article : Google Scholar : PubMed/NCBI
21	Legué LM, Simkens GA, Creemers GJM, Lemmens VEPP and de Hingh IHJT: Synchronous peritoneal metastases of small bowel adenocarcinoma: Insights into an underexposed clinical phenomenon. Eur J Cancer. 87:84–91. 2017. View Article : Google Scholar : PubMed/NCBI