Omari Mouhsine, Al Jarroudi Ouissam, Adil Zaimi, Jaouani Laila, El Attar Hicham, Afqir Said
Medical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital.
Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda.
Ann Med Surg (Lond). 2023 Jun 20;85(8):4100-4105. doi: 10.1097/MS9.0000000000001001. eCollection 2023 Aug.
Primary lung cancer is the leading cause of mortality worldwide. The major sites of lung cancer metastasis are the bones, liver, brain, lung, and adrenal glands. However, secondary localizations in the genital tract are extremely rare.
The authors report the case of a 36-year-old woman who consulted for a right scapular swelling evolving for 4 months associated with a chronic cough. Clinical examination showed a hard fixed right scapular mass with any inflammatory signs. The extension assessment followed by histological analysis concluded in a secondary ovarian location of a lung adenocarcinoma. A very high serum procalcitonin level unrelated to sepsis was detected in the patient along with a substantial hematological paraneoplastic disease. The patient died after 6 months of palliative chemotherapy.
Ovarian localization is found in only 0.4% of metastatic ovarian tumors, which is extremely low, the differentiation between primary and secondary ovarian adenocarcinoma is fundamental since the treatment and prognosis are very different. The serum procalcitonin can be elevated in lung adenocarcinoma.
This case report highlights the interest to encourage doctors to look for ovarian metastasis during the clinical course of lung cancer, and explain the elevation of serum procalcitonin during lung adenocarcinoma.
原发性肺癌是全球主要的死亡原因。肺癌转移的主要部位是骨骼、肝脏、大脑、肺和肾上腺。然而,在生殖道的继发性定位极为罕见。
作者报告了一例36岁女性患者,该患者因右肩胛骨肿胀4个月并伴有慢性咳嗽前来就诊。临床检查发现右肩胛骨有一个坚硬固定的肿块,无任何炎症迹象。进一步的扩展评估及组织学分析结果显示为肺腺癌转移至卵巢。该患者血清降钙素原水平极高,与脓毒症无关,同时还伴有严重的血液学副肿瘤性疾病。患者在接受姑息化疗6个月后死亡。
卵巢转移仅在0.4%的转移性卵巢肿瘤中出现,比例极低,区分原发性和继发性卵巢腺癌至关重要,因为治疗方法和预后差异很大。肺腺癌患者血清降钙素原可能会升高。
本病例报告强调了鼓励医生在肺癌临床过程中寻找卵巢转移灶的重要性,并解释了肺腺癌患者血清降钙素原升高的原因。