COLORECTAL CANCER WITH OVARIAN AND BONE METASTASIS : CASE REPORT

Introduction: Colorectal cancer (RCC) is the third most common cancer worldwide. Metastases being the leading cause of cancer-related mortality. RCC advances from the primary tumor to neighboring organs or structure, implantation into the peritoneum or intra-abdominal organs and through the lymphatic and hematogenous pathways. The main organs involved in metastases are the liver (75%), lungs (15%), bones (5%) and central nervous system (5%). Bone metastasis is rare as is ovarian metastasis. Objectives: To discuss the clinical presentation, diagnosis and therapeutic management of colorectal adenocarcinoma with bone and ovarian metastasis. Methods: Case report of a patient diagnosed with colorectal adenocarcinoma and ovarian metastasis and subsequent bone metastasis. Case Report: Patient ECS, 42 years old, has been coming to the cancer surgery department complaining of lower abdominal pain for 1 month. No findings on physical examination. Evidence of pelvic mass in left ovary topography. The patient underwent exploratory laparotomy that showed right adnexal lesion associated with a stenosing and obstructed lesion in recto-sigmoid transition. He underwent hysterectomy with bilateral adnexectomy, retroperitoneal lymphadenectomy, pelvic lymphadenectomy and Hartman rectosigmoidectomy. Moderately differentiated sigmoid adenocarcinoma result, left ovarian and lymph node metastatic adenocarcinoma, indicating colon tumor as the primary. Pathological staging pT3N1M1. Beginning of palliative chemotherapy. After 6 months the patient begins to report pain in the left knee. PET-Scan suggests lymphadenopathy in the left pulmonary hilum, poorly defined bone sclerosis in the left tibia, and amorphous and irregular tissues in the vaginal dome and nodule between the bladder and distal ureter, indicating neoplastic involvement. Biopsy of tibial lesion showed involvement of metastatic adenocarcinoma with probable colon origin. Discussion and results: RCC is a common cancer, and its main cause of death is liver and lung metastasis. However, bone metastasis is a rare site present in only 3.7 - 11% of clinical cases. Adenocarcinoma metastasis to the ovary is also very rare. Conclusion: It is evident that RCC metastases are common, but in the ovaries and bone they are rare

 

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Artikel online veröffentlicht:
23. Oktober 2019