Wang SD, Zhu L, Wu HW, Dai MH, Zhao YP. Pancreatic cancer with ovarian metastases: A case report and review of the literature. World J Clin Cases 2020; 8(21): 5380-5388 [PMID: 33269273 DOI: 10.12998/wjcc.v8.i21.5380]
Corresponding Author of This Article
Meng-Hua Dai, MD, Doctor, Professor, Surgeon, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing 100730, China. daimh@pumch.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
Shun-Da Wang, Meng-Hua Dai, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Liang Zhu, Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Huan-Wen Wu, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Author contributions: Dai MH and Zhao YP designed the research and approved the final manuscript; Dai MH developed the literature search and carried out the statistical analysis; Wang SD carried out data extraction; Wu HW analyzed the pathology pictures; Zhu L helped to prepare the radiology images; Wang SD wrote the manuscript; all authors read and approved the final manuscript.
Supported byCAMS Innovation Fund for Medical Sciences, No. 2016-I2M-3-005; and Beijing Municipal Science & Technology Commission, No. Z171100001017017018.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: There are no potential 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 that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: Meng-Hua Dai, MD, Doctor, Professor, Surgeon, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing 100730, China. daimh@pumch.cn
Received: July 14, 2020 Peer-review started: July 11, 2020 First decision: August 22, 2020 Revised: August 30, 2020 Accepted: September 17, 2020 Article in press: September 17, 2020 Published online: November 6, 2020
Abstract
BACKGROUND
Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. Most patients are first diagnosed with ovarian cancer. We report a rare case of ovarian metastases secondary to pancreatic adenocarcinoma. We also review the literature to analyze the clinical characteristics of, diagnostic methods for, and perioperative management strategies for this rare malignancy.
CASE SUMMARY
A 48-year-old woman with an abdominal mass presented to our hospital. Computed tomography revealed lesions in the pancreas and lower abdomen. Radiological examination and histological investigation of biopsy specimens revealed either an ovarian metastasis from a pancreatic neoplasm or two primary tumors, with metastasis strongly suspected. The patient simultaneously underwent distal pancreatectomy plus splenectomy by a general surgeon and salpingo-oophorectomy with hysterectomy by a gynecologist. Histological examination of the surgical specimen revealed a pancreatic adenocarcinoma (intermediate differentiation, mucinous) and a metastatic mucinous adenocarci-noma in the ovary.
CONCLUSION
For this rare tumor, surgical resection is the most effective treatment, and the final diagnosis depends on tumor pathology.
Core Tip: We report a case of pancreatic adenocarcinoma with ovarian metastasis. Pancreatic cancer with ovarian metastases is asymptomatic in the early stages, progressing rapidly thereafter. Systematic guidelines for this disease are currently lacking. Many patients have been diagnosed with ovarian tumors without obvious abdominal symptoms, which demonstrates the challenge of detecting pancreatic malignancies early. Surgery is the optimal treatment, and pathological examination of the surgical specimen can reveal the final diagnosis. Prognosis depends on pathological type and stage. Clinicians should consider these factors while treating patients with similar symptoms. Early diagnosis of this disease will help in developing an effective treatment strategy.
