Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3872-3880
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3872
Peritoneal cancer after bilateral mastectomy, hysterectomy, and bilateral salpingo-oophorectomy with a poor prognosis: A case report and review of the literature
Ya-Na Ma, Hua-Lei Bu, Cheng-Juan Jin, Xia Wang, You-Zhong Zhang, Hui Zhang
Ya-Na Ma, Hua-Lei Bu, Xia Wang, You-Zhong Zhang, Hui Zhang, Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
Cheng-Juan Jin, Department of Obstetrics and Gynecology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201620, China
Author contributions: Ma YN and Bu HL contributed equally to this work. Ma YN and Bu HL wrote and edited the article; Jin CJ assisted in editing the article; Wang X and Zhang YZ managed the patient; Zhang H was the patient’s physician.
Informed consent statement: Informed consent was obtained from the patient included in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hui Zhang, Department of Obstetrics and Gynecology, Qilu Hospital, Shandong University, 107 Wenhua Xi Road, Jinan 250012, Shandong Province, China. williamzh@sdu.edu.cn
Telephone: +86-531-82169269 Fax: +86-531-82169268
Received: July 2, 2019
Peer-review started: July 12, 2019
First decision: September 9, 2019
Revised: September 19, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: November 26, 2019
Abstract
BACKGROUND

Primary peritoneal cancer (PPC) patients with BRCA mutations have a good prognosis; however, for patients with BRCA mutations who are diagnosed with PPC after prophylactic salpingo-oophorectomy (PSO), the prognosis is poor, and survival information is scarce.

CASE SUMMARY

We treated a 56-year-old woman with PPC after bilateral mastectomy, hysterectomy, and bilateral salpingo-oophorectomy. This patient had primary drug resistance and died 12 mo after the diagnosis of PPC. The genetic test performed on this patient indicated the presence of a germline BRCA1 mutation. We searched the PubMed, Scopus, and Cochrane databases and extracted studies of patients with BRCA mutations who developed PPC after PSO. After a detailed literature search, we found 30 cases, 7 of which had a history of breast cancer, 14 of which had no history of breast cancer, and 9 of which had an unknown history. The average age of PSO patients was 48.86 years old (range, 31-64 years). The average time interval between the diagnosis of PPC and preventive surgery was 61.03 mo (range, 12-292 mo). The 2-year survival rate for this patient population was 78.26% (18/23), the 3-year survival rate was 50.00% (9/18), and the 5-year survival rate was 6.25% (1/16).

CONCLUSION

Patients with BRCA mutations who are diagnosed with PPC after preventative surgery have a poor prognosis. Prevention measures and treatments for these patients need more attention.

Keywords: Prophylactic salpingo-oophorectomy, BRCA, Primary peritoneal cancer, Prognosis, Case report

Core tip: To the best of our knowledge, this is the first article to describe the survival and prognosis of primary peritoneal cancer (PPC) after prophylactic salpingo-oophorectomy (PSO) in patients with hereditary breast and ovarian cancer. Previous studies have shown that PPC patients with BRCA mutations have better therapeutic outcomes and prognosis, but the patient we reported showed primary resistance to initial treatment and only survived for 12 mo. We found that the 3-year survival rate was 50.00% (9/18) and the 5-year survival rate was only 6.25% (1/16) for patients with PPC after PSO, which is different from our previous perceptions, and these results are surprising.