Wang Shun-Da, Dai Meng-Hua, Zhao Yu-Pei
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Transl Cancer Res. 2020 Dec;9(12):7652-7656. doi: 10.21037/tcr-20-2361.
Pancreatic cystadenocarcinoma with ovarian metastases is rare and easily misdiagnosed as primary ovarian cancers. Here we report 38-year-old female manifested tumors in pancreas and ovary concurrently, which was difficult to distinguish the primary site. She was admitted to hospital because of abdominal distension and a palpable mass in the lower abdomen. Abdominal ultrasound showed a lesion in pancreas and two masses in bilateral ovaries. Computed tomography (CT) revealed the hypo-enhancing pancreatic mass and the large pelvic lesion simultaneously. The largest cross-sectional of the right mass was 12×15.1 cm and 15.4×18.3 cm for the left side, probably malignant lesions. In addition, the level of the serum CA19-9 and CA125 were higher than the normal level. Positron emission tomography CT (PET-CT) revealed there might be the cystadenocarcinoma in the pancreatic tail with multiple metastatic lesions implanted in the pelvic. After comprehensive examination, she received bilateral salpingo-oophorectomy and biopsy of the pancreatic tumor. The pathological finding revealed that it was pancreatic cystadenocarcinoma with ovarian metastases. Postoperatively, she received the chemotherapy and the follow-up continued for 26 months until she died. This case reminded doctors that pancreatic primaries should be paid attention when dealing with metastatic ovarian malignancies although it was rare. Choosing effective diagnostic method and timely surgical intervention are essential to improve prognosis.
伴有卵巢转移的胰腺囊腺癌较为罕见，且容易被误诊为原发性卵巢癌。在此，我们报告一名38岁女性，其胰腺和卵巢同时出现肿瘤，难以区分原发部位。她因腹胀和下腹部可触及肿块入院。腹部超声显示胰腺有一个病变，双侧卵巢有两个肿块。计算机断层扫描（CT）同时显示胰腺肿块呈低密度强化以及盆腔有较大病变。右侧肿块最大横截面为12×15.1厘米，左侧为15.4×18.3厘米，可能为恶性病变。此外，血清CA19-9和CA125水平高于正常水平。正电子发射断层扫描CT（PET-CT）显示胰尾可能存在囊腺癌，盆腔有多个转移病灶。经过全面检查，她接受了双侧输卵管卵巢切除术及胰腺肿瘤活检。病理结果显示为伴有卵巢转移的胰腺囊腺癌。术后，她接受了化疗，并持续随访26个月直至死亡。该病例提醒医生，尽管转移性卵巢恶性肿瘤中胰腺原发灶罕见，但在处理时仍应予以关注。选择有效的诊断方法并及时进行手术干预对于改善预后至关重要。
