Abstract
Rectal perforation is uncommon in ovarian cancer, even in advanced stages. Pure primary ovarian squamous cell carcinoma is a very rare subtype of ovarian cancer and has not been reported to cause rectal perforation. A 50-year-old woman presented with rectal bleeding. Rectosigmoidoscopy suggested perforation of a pelvic tumor into the rectum. Abdominopelvic magnetic resonance imaging revealed a 9 cm heterogeneous mass in the pouch of Douglas. We performed complete cytoreduction, including an en-bloc resection of the tumor and rectosigmoid colon. Histopathology showed squamous cell carcinoma of the left ovary penetrating the rectal wall. A common symptom of rectal bleeding was caused by a very rare entity of ovarian cancer penetrating the rectal wall, but thorough evaluation led to its accurate diagnosis and appropriate treatment.
Highlights
Ovarian squamous cell carcinomas are uncommon, with most arising from malignant transformation of a mature cystic teratoma
Fistulae communicating with the bladder, rectum, and intestine are reported in malignant transformation of mature cystic teratoma [3, 4], perforation by a pure primary ovarian squamous cell carcinoma has not been reported
We describe the first case to be reported of pure primary ovarian squamous cell carcinoma perforating the rectum, which caused a common symptom of rectal bleeding
Summary
Ovarian squamous cell carcinomas are uncommon, with most arising from malignant transformation of a mature cystic teratoma. A few appear in pure form [1, 2]. Most patients with ovarian cancer present at an advanced stage and have a poor prognosis. Invasion into the serosal and muscular layer of the sigmoid colon and rectum by advanced ovarian cancer is common, but colorectal perforation is an extremely rare presentation. Fistulae communicating with the bladder, rectum, and intestine are reported in malignant transformation of mature cystic teratoma [3, 4], perforation by a pure primary ovarian squamous cell carcinoma has not been reported. We present a case of pure primary ovarian squamous cell carcinoma perforating the rectum
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