Kemps Paul Geraeds, Bol Mijke, Steller Ernst Johan Abraham, de Pont Lisa Maria Henrica, Holterhues Cynthia, van Gerven Leander, Kolkman Wendela
Department of Gynecology and Obstetrics, Haga Hospital, The Hague, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands.
Radiol Case Rep. 2021 Jul 23;16(9):2799-2803. doi: 10.1016/j.radcr.2021.06.072. eCollection 2021 Sep.
An adnexal mass is a common gynecological finding. Most adnexal masses are benign neoplasms, especially in premenopausal women. Yet, here we report a premenopausal woman with an adnexal mass that turned out to be an ovarian metastasis from colon cancer. This case emphasizes the importance of considering an ovarian metastasis in patients with (partially) solid adnexal masses and low serum CA125 levels. In addition, we identified the same mutation in the biopsied liver metastasis and resected right ovarian metastasis. This is in accordance with a previous molecular study of matched tumor pairs/trios of colorectal cancer patients with ovarian metastases, suggesting that mutated is a universal driver of the metastatic disease in women with -mutated colorectal cancer with ovarian metastases. More than half of all colorectal cancer patients with ovarian metastases harbor mutations. Future studies may investigate the efficacy of KRAS inhibitors in the treatment of these patients.
附件包块是常见的妇科检查发现。大多数附件包块是良性肿瘤，尤其是在绝经前女性中。然而，我们在此报告一名绝经前女性，其附件包块最终被证实为结肠癌的卵巢转移瘤。该病例强调了对于（部分）实性附件包块且血清CA125水平较低的患者，考虑卵巢转移的重要性。此外，我们在活检的肝转移灶和切除的右侧卵巢转移灶中发现了相同的突变。这与先前一项针对伴有卵巢转移的结直肠癌患者配对肿瘤/三联体的分子研究结果一致，提示KRAS突变是伴有KRAS突变的结直肠癌且发生卵巢转移的女性患者转移性疾病的普遍驱动因素。超过一半的伴有卵巢转移的结直肠癌患者存在KRAS突变。未来的研究可探讨KRAS抑制剂治疗这些患者的疗效。
