Nakamura Miwa, Mitsuhashi Akira, Tanaka Naotake, Nagai Yuichiro, Shozu Makio
Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
J Obstet Gynaecol Res. 2011 Apr;37(4):366-9. doi: 10.1111/j.1447-0756.2010.01355.x. Epub 2011 Jan 27.
Metastasis of ovarian carcinoma to the small bowel parenchyma without peritoneal dissemination is uncommon. A 63-year-old woman underwent surgery for a clear cell adenocarcinoma of the ovary and received adjuvant chemotherapy. Eighteen months after the operation, she presented with recurrent occult bowel hemorrhage without evidence of an abdominal mass. Nine months later, a rapidly growing abdominal mass was detected. Laparoscopy revealed a solitary tumor of the ileum covered with an intact serosal layer. Partial ileectomy was performed for tumor resection. Histological examination revealed cells resembling the primary ovarian tumor in the mucosal surface of the small bowel along with an intact serosa. The tumor cells were positive for cytokeratin 7 and negative for cytokeratin 20, suggesting an ovarian origin. This is the first report of solitary metastasis of an ovarian carcinoma to the small bowel parenchyma without peritoneal dissemination. Metastasis to the small bowel should be considered in ovarian carcinoma patients with occult gastrointestinal hemorrhage.
卵巢癌转移至小肠实质而无腹膜播散的情况并不常见。一名63岁女性因卵巢透明细胞腺癌接受了手术，并接受了辅助化疗。术后18个月，她出现反复隐匿性肠道出血，未发现腹部肿块。9个月后，检测到一个迅速增大的腹部肿块。腹腔镜检查发现回肠有一个孤立性肿瘤，浆膜层完整。行部分回肠切除术以切除肿瘤。组织学检查显示小肠黏膜表面有类似于原发性卵巢肿瘤的细胞，浆膜层完整。肿瘤细胞细胞角蛋白7阳性，细胞角蛋白20阴性，提示起源于卵巢。这是首例卵巢癌孤立性转移至小肠实质而无腹膜播散的报道。对于有隐匿性胃肠道出血的卵巢癌患者，应考虑小肠转移的可能。
