Taylor R R, Phillips W S, O'Connor D M, Harrison C R
Department of Obstetrics and Gynecology, National Naval Medical Center and Uniformed Services University of the Health Sciences, Bethesda, Maryland 20889.
Gynecol Oncol. 1994 Oct;55(1):152-5. doi: 10.1006/gyno.1994.1266.
Epithelial ovarian carcinoma regularly metastasizes to peritoneal surfaces throughout the abdomen and pelvis. Gastrointestinal involvement is usually limited to seromuscular involvement of the small and large bowel and its mesentery. Gastrointestinal invasion is most often superficial, mesentery is shortened, and intestinal lumens are narrowed. Transmural invasion is less common, as is gastrointestinal hemorrhage. We present a case of life-threatening intralumenal gastric hemorrhage from an intramural gastric metastasis of epithelial ovarian carcinoma effectively palliated with a gastric resection. Intralumenal gastric metastasis represents an unusual trophism of recurrent epithelial ovarian carcinoma. Surgical intervention for life-threatening hemorrhage, while not curative, may provide effective palliation in the otherwise fully functional patient and thereby reducing the need for medical attention and the anxiety assigned to recurrent gastrointestinal hemorrhage. Palliative maneuvers for gastric metastasis may require a multidisciplinary approach.
上皮性卵巢癌常转移至整个腹部和盆腔的腹膜表面。胃肠道受累通常局限于小肠、大肠及其系膜的浆肌层受累。胃肠道侵犯最常见的是浅表性的,系膜缩短,肠腔变窄。全层侵犯较少见,胃肠道出血也较少见。我们报告一例因上皮性卵巢癌壁内胃转移导致危及生命的胃腔内出血,经胃切除有效缓解。胃腔内转移是复发性上皮性卵巢癌一种不寻常的趋向性。针对危及生命的出血进行手术干预虽不能治愈,但可在其他方面功能正常的患者中提供有效的缓解,从而减少医疗护理需求以及因复发性胃肠道出血带来的焦虑。针对胃转移的姑息性措施可能需要多学科方法。