Department of Obstetrics and Gynecology, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, China.
Department of Obstetrics and Gynecology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40202. doi: 10.1097/MD.0000000000040202.
Ovarian carcinosarcoma (OCS) is a rare malignant tumor prone to distant metastasis. Primary manifestations include pelvic and/or abdominal pain, bloating, and compression. Nevertheless, it is uncommon for OCS to present primarily with persistent fever. This is the first reported case of OCS with lung metastasis characterized by persistent fever.
A 61-year-old female patient complaining of abdominal pain and fever was admitted to our hospital. Computed tomography showed an irregular, slightly low-density mass on the left side of the uterus and multiple solid nodules in both lungs.
She underwent cytoreductive surgery for pathologically confirmed stage IVB OCS.
She was administered chemotherapy after cytoreductive surgery. Given the patient's history of persistent fever and progressively enlarged pulmonary nodules, a pulmonary abscess was considered as a possible diagnosis. Following antibiotic therapy, the patient's high body temperature did not decrease; however, following nonsteroidal anti-inflammatory drug therapy, it quickly decreased. These symptoms were eventually considered the consequence of neoplastic fever caused by lung metastases.
Owing to the rapid progression of the disease, the patient ultimately died.
This study suggests that, for patients with pelvic and/or abdominal pain, bloating, and pelvic masses, especially those with suspicious lesions in other organs accompanied by fever of unknown origin, a diagnosis of cancer or sarcoma with metastasis should be considered after ruling out infectious fever.
卵巢癌肉瘤（OCS）是一种罕见的恶性肿瘤，易发生远处转移。主要表现为盆腔和/或腹部疼痛、腹胀和压迫感。然而，OCS 以持续性发热为首发表现的情况并不常见。这是首例以持续性发热为主要表现的伴有肺转移的 OCS 病例报告。
一名 61 岁女性患者因腹痛和发热就诊于我院。计算机断层扫描显示子宫左侧不规则、略低密度肿块，双肺多发实性结节。
患者接受了经病理证实的 IVB 期 OCS 的细胞减灭术。
细胞减灭术后，给予患者化疗。鉴于患者持续性发热且肺部结节逐渐增大，考虑肺脓肿为可能的诊断。抗生素治疗后，患者高热未降；而非甾体抗炎药治疗后，体温迅速下降。这些症状最终被认为是肺转移引起的肿瘤性发热的结果。
由于疾病迅速进展，患者最终死亡。
本研究表明，对于有盆腔和/或腹部疼痛、腹胀和盆腔肿块的患者，尤其是那些伴有其他器官可疑病变和不明原因发热的患者，在排除感染性发热后，应考虑癌症或肉瘤伴转移的诊断。
