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Zhang J, He W, Zhang Z, Dong H, Deng X, Wen Q, Li D. Skin metastasis from ovarian cancer with somatic BRCA1 mutation: A case report and literature review. Oncol Lett 2024; 28:348. [PMID: 38872856 PMCID: PMC11170256 DOI: 10.3892/ol.2024.14481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/08/2024] [Indexed: 06/15/2024] Open
Abstract
Skin metastasis from ovarian cancer is rare, and its prognosis is poor. Effective therapeutic strategies are currently lacking, but the combination of various treatment methods shrink the tumor and relieve symptoms. The present study reports a rare case of advanced ovarian cancer with skin metastases and intestinal wall thickening, along with a BRCA1 DNA repair associated (BRCA1) mutation. After standard first-line treatment and non-standard second-line treatment, the patient developed skin metastases. The patient's skin itching, pain and lesions were completely relieved after administering bevacizumab in combination with paclitaxel and carboplatin. After 4 months, skin metastases recurred along with anal distension during maintenance treatment with oral poly(ADP ribose) polymerase (PARP) inhibitors. The patient was treated again with bevacizumab combined with docetaxel, and the anal distension was significantly relieved. Angiogenesis therapy combined with chemotherapy is effective, but that the disease-free survival time is short, and PARP inhibitor maintenance effect is limited even in cases with a BRCA1 gene mutation.
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Affiliation(s)
- Jingheng Zhang
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Department of Oncology, Luzhou People's Hospital, Luzhou, Sichuan 646000, P.R. China
| | - Wenfeng He
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Zhenhua Zhang
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Hui Dong
- Department of Pathology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Xiangyu Deng
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
| | - Qinglian Wen
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- Department of Radiotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610044, P.R. China
| | - Dan Li
- Department of Oncology, Affiliated Hospital of Clinical School of Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
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Suzuki Y, Eguchi S, Arimoto T. Late Recurrence of Ovarian Cancer after 18 Years of Disease-Free Survival: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2024; 2024:3938833. [PMID: 38304761 PMCID: PMC10830924 DOI: 10.1155/2024/3938833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
We present a case of recurrent ovarian cancer at the age of 75, gravida 1 para 0, with 18 years of disease-free survival. Chemotherapy brought a 10-month partial response status; to further improve the overall survival, the patient was evaluated using the AGO score (DESKTOP III trial, 2020), which was originally intended for cases immediately after the diagnosis of recurrence; the score has indicated a significant outcome; the patient went through a hepatosplenic metastatic site resection; and complete resection was achieved. Subsequently, the PARP inhibitor was introduced, which has led to 14 months of disease-free survival. Fifteen cases of late recurrence of epithelial ovarian cancer have been reported and are summarized at the end of this paper.
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Chiba M, Goto T, Sato W, Shibuya T, Takahashi K, Minami S, Matsuzawa H, Sato Y, Iijima K. Extremely Late Recurrence of Ovarian Carcinoma Diagnosed by an Endoscopic Ultrasound-guided Fine-needle Biopsy. Intern Med 2021; 60:247-250. [PMID: 32921693 PMCID: PMC7872809 DOI: 10.2169/internalmedicine.5693-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
We herein report a case of recurrence of epithelial ovarian carcinoma 41 years after the primary surgery that was diagnosed by an endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). The differential diagnosis based on the imaging findings was difficult. We performed an EUS-FNB and compared the EUS-FNB specimen to the surgical specimen that had been resected in the primary surgery for ovarian carcinoma 41 years earlier, including immunohistochemical staining. Finally, we made a definitive diagnosis of extremely late recurrence of ovarian carcinoma of the retroperitoneum. An EUS-FNB enables an accurate histological diagnosis by obtaining a sample that is large enough to perform immunohistochemical staining.
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Affiliation(s)
- Mitsuru Chiba
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Takashi Goto
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Wataru Sato
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Tomomi Shibuya
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Kenichi Takahashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Shinichiro Minami
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Hisanori Matsuzawa
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Yuki Sato
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
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Omura A, Kimura K, Taniguchi S, Shintani Y. Thymic Metastasis of Ovarian Cancer 33 Years After Primary Surgery. Ann Thorac Surg 2020; 111:e361-e363. [PMID: 33130116 DOI: 10.1016/j.athoracsur.2020.07.094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
This report describes a case of an extremely late recurrence of thymic metastasis after radical resection of ovarian cancer. Chest computed tomography demonstrated anterior mediastinal nodules with a smooth marginal area in a 56-year-old woman who had undergone an oophorectomy for ovarian cancer 33 years earlier. Because imaging findings suggested a thymic epithelial tumor, a partial thymectomy was performed. Histopathologic results led to the diagnosis of thymic metastasis of ovarian cancer. In patients with a medical history of ovarian cancer, thymic metastasis should be considered in the differential diagnosis of thymic tumor.
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Affiliation(s)
- Akiisa Omura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Seiji Taniguchi
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Inoue E, Yotsumoto T, Inoue Y, Fukami T, Kitani M, Hirano Y, Nagase M, Morio Y. Mediastinal metastasis from ovarian serous carcinoma 29 years after initial treatment. Respir Med Case Rep 2020; 29:101003. [PMID: 32257787 PMCID: PMC7118409 DOI: 10.1016/j.rmcr.2020.101003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/19/2020] [Indexed: 12/01/2022] Open
Abstract
Ovarian cancer is a critically lethal gynecologic malignancy. More than 80% of patients with ovarian cancer have relapses within 5 years after initial treatment. However, recurrence from ovarian cancer more than 20 years later is extremely rare. We report a case of a 67-year-old female with mediastinal metastasis from ovarian cancer 29 years after initial gynecologic surgery and chemotherapy.
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Affiliation(s)
- Eri Inoue
- Center for Pulmonary Diseases, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Takuma Yotsumoto
- Center for Pulmonary Diseases, Department of Thoracic Surgery, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Yuta Inoue
- Center for Pulmonary Diseases, Department of Thoracic Surgery, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Takeshi Fukami
- Center for Pulmonary Diseases, Department of Thoracic Surgery, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Masashi Kitani
- Department of Diagnostic Pathology, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Yuta Hirano
- Center for Pulmonary Diseases, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Maki Nagase
- Center for Pulmonary Diseases, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
| | - Yoshiteru Morio
- Center for Pulmonary Diseases, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan.,Center for Pulmonary Circulation and Hemoptysis, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan
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Cutaneous Metastases in Ovarian Cancer. Cancers (Basel) 2019; 11:cancers11091292. [PMID: 31480743 PMCID: PMC6788186 DOI: 10.3390/cancers11091292] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 12/12/2022] Open
Abstract
Skin metastases in ovarian cancer are uncommon, but their incidence may be increasing due to improved survival rates. Skin metastases can be divided into umbilical metastases, which are known as Sister Joseph nodules (SJNs) and are associated with peritoneal metastasis, and non-SJN skin metastases, which usually develop within surgical scars and in the vicinity of superficial lymphadenopathy. As most skin metastases develop after specific conditions, recognition of preceding metastatic diseases and prior treatments is necessary for early diagnosis of skin lesions. The prognosis of skin metastases in ovarian cancer varies widely since they are heterogeneous in the site of lesion and the time of appearance. Patients with SJNs at initial diagnosis and patients with surgical scar recurrences without concomitant metastases may have prolonged survival with a combination of surgery and chemotherapy. In patients who developed skin recurrences as a late manifestation, symptoms should be treated with external beam radiotherapy and immune response modifiers. Immune checkpoint blockade can enhance anti-tumor immunity and induce durable clinical responses in multiple tumor types, including advanced chemoresistant ovarian cancer. With the use of radiation therapy, which enhances the systemic anti-tumor immune response, immune checkpoint blockade may be a promising therapeutic strategy for distant metastasis, including skin metastasis.
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Izuishi K, Sano T, Usuki H, Okano K, Masaki T, Kushida Y, Suzuki Y. Isolated Splenic Metastasis of Ovarian Cancer 20 Years after Operation: A Case Report and Literature Review. TUMORI JOURNAL 2018; 96:784-6. [DOI: 10.1177/030089161009600525] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Splenic metastasis reflecting multiple metastases of cancer is often observed in the terminal stage, although solitary splenic metastasis is extremely rare. In addition, late recurrence even after 20 years of operation is very unusual. We report the case of a 52-year-old woman who was admitted to our department with a splenic tumor. She had a past history of total abdominal hysterectomy with bilateral sapingo-oophorectomy for ovarian cancer 20 years ago. Abdominal CT scan revealed a huge mass of 12 × 8 × 5.5 cm between the spleen and the left kidney. Splenectomy was performed with a diagnosis of splenic tumor. Microscopically, the tumor was a poorly differentiated adenocarcinoma including components of poorly differentiated ovarian cancer, and was diagnosed as an ovarian cancer metastasis. The patient showed no evidence of recurrence until 5 years postoperatively. Splenic metastasis is considered a terminal stage of cancer. However, when the lesion is solitary, surgical treatment is recommended. Free full text available at www.tumorionline.it
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Affiliation(s)
| | - Takanori Sano
- Department of Gastroenterological Surgery, Kita, Kagawa, Japan
| | - Hisashi Usuki
- Department of Gastroenterological Surgery, Kita, Kagawa, Japan
| | - Keiichi Okano
- Department of Gastroenterological Surgery, Kita, Kagawa, Japan
| | - Tsutomu Masaki
- Department of Gastroenterology and Neurology, Kita, Kagawa, Japan
| | - Yoshio Kushida
- Department of Pathology, Faculty of Medicine, Kagawa University, Kita, Kagawa, Japan
| | - Yasuyuki Suzuki
- Department of Gastroenterological Surgery, Kita, Kagawa, Japan
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Otsuka I, Shoji K. Paraaortic node recurrence 25 years after removal of epithelial ovarian carcinoma. J Obstet Gynaecol Res 2016; 42:1609-1612. [PMID: 27641229 DOI: 10.1111/jog.13115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/18/2016] [Indexed: 11/30/2022]
Abstract
In epithelial ovarian carcinoma, very late (more than 20 years) recurrence is an unusual event. In patients experiencing such a recurrence, the effectiveness of platinum/taxane chemotherapy has been questioned. A 54-year old woman presented with paraaortic node swelling that appeared 25 years after treatment of stage I epithelial ovarian carcinoma. She underwent a partial resection of the nodes and histologic examination showed high-grade serous carcinoma. She received paclitaxel and carboplatin chemotherapy and a partial response was initially observed on imaging studies; however, serum cancer antigen125 levels increased thereafter. She received radiation therapy to the paraaortic nodal disease with doses of 45 Gy and achieved a complete response. She was disease-free more than eight years after the detection of recurrence. In conclusion, radiation therapy may be an effective treatment option in patients with very late recurrence of epithelial ovarian carcinoma refractory to platinum/taxane chemotherapy.
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Affiliation(s)
- Isao Otsuka
- Department of Gynecology, Kameda Medical Center, Kamogawa, Japan.
| | - Kazufusa Shoji
- Department of Radiology, Kameda Medical Center, Kamogawa, Japan
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Menczer J, Schreiber L, Peled O, Levy T. Very late recurrence (after more than 20 years) of epithelial ovarian carcinoma: case report and literature review. Arch Gynecol Obstet 2014; 291:1199-203. [PMID: 25524538 DOI: 10.1007/s00404-014-3597-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/09/2014] [Indexed: 12/13/2022]
Abstract
PURPOSE To present a case of very late (more than 20 years) recurrence of epithelial ovarian carcinoma and to review the pertinent literature. We encountered a 50-year-old patient who, at the age of 22, underwent cytoreductive surgery and adjuvant chemotherapy for stage III serous ovarian carcinoma. She recurred after 28 years and underwent secondary surgery and chemotherapy. METHOD A PubMed search of the English literature containing the following key words: ovarian cancer, late recurrence, late relapse, late metastasis was performed. RESULTS Only five cases (including the present one) with recurrence after more than 20 years are so far on record. Of these, four patients were 33 years old or younger and had advanced stage at diagnosis. Time to recurrence ranged from 21 to 28 years. All patients had serous carcinoma and three had recurrence in lymph nodes. CONCLUSIONS Very late recurrence is an extremely rare event and may result from either regrowth of dormant tumor cells or from development of a new cancer. Lifelong follow-up is critically important for ovarian cancer patients.
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Affiliation(s)
- Joseph Menczer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, E. Wolfson Medical Center, Holon, Israel,
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Erşahin C, Omeroglu G, Hammadeh R. Pathologic quiz case: a lymph node lesion in a 58-year-old woman with invasive high-grade urothelial carcinoma. Lymph node inclusion of serous borderline tumor. Arch Pathol Lab Med 2005; 129:537-8. [PMID: 15794683 DOI: 10.5858/2005-129-537-pqcaln] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Cağatay Erşahin
- Department of Pathology, Loyola University Medical Center, Maywood, Ill 60153, USA
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