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Abstract
High-grade serous ovarian cancer (HGSOC) is the most common and also the most aggressive subtype of ovarian cancer while squamous cell carcinoma (SCC) of the colon is an extremely rare histologic subtype of all colonic malignancies with poor prognosis. Here we report a unique case of synchronous primary SCC of the colon and second recurrence of HGSOC in a patient with 15-years survival. Our patient developed two recurrent HGSOCs with disease-free survival time of five and nine years, respectively. The second recurrence of HGSOC was associated with the synchronous primary SCC of the ascending colon and was further complicated with the patient′s development of platinum resistance. Awareness of this unusual occurrence should emphasize the need for adequate sampling of tumor tissue in patients with relapsing ovarian cancer. Reports of more cases of SCC of the colon would possibly help to establish appropriate management modality and strategies for treatment.
Highlights
Ovarian cancer is the most lethal malignancy of the female reproductive tract and high-grade serous ovarian cancer (HGSOC) is the most common and the most aggressive histologic subtype.[1]Please cite this paper as: Sladoljev K, Perin E, Ferrari AM, Klarić M, Brnčić-Fischer A, Eminović S, Vrdoljak-Mozetič D, Babarovic E
We report an interesting case of a HGSOC patient with 15-year survival
The second recurrence of HGSOC was associated with a synchronous primary squamous cell carcinoma (SCC) of the ascending colon and was further complicated by the patient′s development of platinum resistance
Summary
Ovarian cancer is the most lethal malignancy of the female reproductive tract and high-grade serous ovarian cancer (HGSOC) is the most common and the most aggressive histologic subtype.[1]. Re-evaluation of whole body PET-CT scan with FDG showed high metabolic activity in the wall and adjacent adipose tissue of the ascending colon, multiple smaller peritoneal infiltrates and a few enlarged mesenteric lymph nodes. Tumor cells of primary ovarian tumor and serosal metastatic infiltrates were both CK7 and WT1 diffusely positive and p53 showed a complete absence of nuclear staining with 0% of positive nuclear staining (Figure 1D-F). After the fourth cycle of chemotherapy, a reevaluation of whole body PET-CT scan with FDG was performed and disease progression was revealed. After the fourth cycle of mono chemotherapy the patient developed neurological side effects and enterocolitis, but the serum CA-125 level was decreasing and regular abdominal ultrasound examinations, CT and MR of the brain did not reveal signs of progression. The patient developed severe obstructive jaundice due to progression of the disease and eventually passed away 25 months after the last surgery and 15 years and 9 months after the first diagnosis of HGSOC
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