Department of Obstetrics and Gynecology, Aidu Chuo Hospital, Fukushima, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
BMC Womens Health. 2022 Apr 5;22(1):103. doi: 10.1186/s12905-022-01684-3.
Epithelial ovarian cancer is the most frequent gynecologic malignancy; it has a poor prognosis and often occurs bilaterally. Most cases of synchronous bilateral ovarian cancer (SBOC) are metastases from the other ovary, while bilateral primary ovarian cancer is rare.
The patient was a 47-year-old Japanese woman with a complaint of abdominal pain for 1 month. Imaging results revealed bilateral ovarian tumors with suspicion of malignancy. The patient underwent a laparotomy with total hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy, and resection of suspected dissemination in the peritoneum. Histopathological and immunohistochemical studies showed that the right ovarian tumor was an endometrioid carcinoma (G2) and had no association with endometriotic lesions. However, the left ovarian tumor was a high-grade serous carcinoma (HGSC). The final staging was stage 1 right endometrioid carcinoma and stage IIb left HGSC. Six courses of adjuvant chemotherapy with paclitaxel, docetaxel, and carboplatin were administered. The patient showed no signs of recurrence 24 months postoperatively.
To the best of our knowledge, the combination of histological types in this case may be the first report of primary bilateral ovarian cancer. In SBOC, it is important to differentiate the subtypes of histology using immunostaining, in addition to morphopathology.
上皮性卵巢癌是最常见的妇科恶性肿瘤；它预后不良，常为双侧发病。大多数双侧卵巢同时性癌（SBOC）是来自对侧卵巢的转移，而双侧原发性卵巢癌则较为罕见。
患者为 47 岁日本女性，因腹痛 1 个月就诊。影像学结果提示双侧卵巢肿瘤，疑为恶性。患者接受了剖腹手术，包括全子宫切除术、双侧附件切除术、部分网膜切除术以及疑似腹膜播散灶切除术。组织病理学和免疫组织化学研究显示，右侧卵巢肿瘤为子宫内膜样癌（G2），与子宫内膜异位症病变无关。然而，左侧卵巢肿瘤为高级别浆液性癌（HGSC）。最终分期为右侧子宫内膜样癌 1 期和左侧 HGSC 2b 期。患者接受了紫杉醇、多西他赛和卡铂辅助化疗 6 个疗程。术后 24 个月无复发迹象。
据我们所知，这种组织学类型的组合可能是首例原发性双侧卵巢癌的报告。在 SBOC 中，除了形态病理学外，使用免疫组化来区分组织学亚型也很重要。
