卵巢癌转移继发胃穿孔：病例报告
Gastric perforation secondary to metastasis from ovarian cancer: Case report.
作者信息
Obeidat Firas, Mismar Ayman, Shomaf Maha, Yousef Mohammad, Fram Kamil
机构信息
Department of General Surgery, The University of Jordan, Amman, Jordan.
出版信息
Int J Surg Case Rep. 2013;4(6):541-3. doi: 10.1016/j.ijscr.2013.03.002. Epub 2013 Mar 16.
INTRODUCTION
Metastasis from ovarian cancer occurs frequently through the peritoneal cavity in the form of peritoneal carcinomatosis; isolated gastric metastasis is rarely reported in literature.
PRESENTATION OF CASE
We present a case of 43-year-old infertile lady, who developed a picture of acute abdomen four days post total abdominal hysterectomy and salpingoopherectomy for ovarian cancer. Further contrast-enhanced CT scan demonstrated massive free gas and fluid in the abdomen. She underwent antrectomy with truncal vagotomy due to 3cm×4cm prepyloric gastric ulcer. Final pathology proved the presence of metastatic serous cystadenocarcinoma of ovarian origin.
DISCUSSION
Our patient had a gastric perforation secondary to ovarian metastasis. Being isolated, the absence of ascites and the transmural nature of the gastric metastasis suggest haematogenous spread .To the best of our knowledge perforated gastric metastasis secondary to ovarian cancer was not reported in literature before.
CONCLUSION
Gastric metastasis should be kept in mind in patients with a well-known ovarian cancer who present with gastric lesions, ulcers, bleeding or perforation.
引言
卵巢癌转移常通过腹膜腔以腹膜癌病的形式发生；孤立性胃转移在文献中鲜有报道。
病例介绍
我们报告一例43岁的不孕女性，她在因卵巢癌行全腹子宫切除术和输卵管卵巢切除术后四天出现急腹症表现。进一步的增强CT扫描显示腹部有大量游离气体和液体。由于存在3cm×4cm的幽门管胃溃疡，她接受了胃窦切除术加迷走神经干切断术。最终病理证实存在卵巢来源的转移性浆液性囊腺癌。
讨论
我们的患者因卵巢转移继发胃穿孔。由于是孤立性的，没有腹水且胃转移为透壁性，提示血行播散。据我们所知，此前文献中未报道过卵巢癌继发穿孔性胃转移。
结论
对于患有已知卵巢癌且出现胃部病变、溃疡、出血或穿孔的患者，应考虑胃转移的可能。
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