Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5380
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
Processing time: 115 Days and 4.9 Hours
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.
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.
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.