Recognizing Recurrent Ovarian Endometrioid Carcinoma: A Case of Malignant Sigmoid Serosa Lesion Mimicking a Mesenteric Cyst

Introduction Endometrioid carcinoma (EC) of the ovary typically presents in the fifth to sixth decade of life, arising from endometriosis or benign adenofibromas. While commonly metastasizing intraperitoneally, hematogenous spread to distant sites is rare. We present a unique case of recurrent EC manifesting as a malignant sigmoid colon cyst, a clinical rarity. Case Report A 43-year-old woman, previously treated for left ovarian EC, presented with abdominal pain and distension. Imaging revealed a mesenteric cyst, but elevated CA-125 levels prompted further investigation. PET-CT scan identified a cystic mass arising from the sigmoid colon. Secondary cytoreductive surgery confirmed recurrent EC without colonic endometriosis. Immunohistochemistry supported the diagnosis of TP-53 mutant EC.

This case underscores the importance of considering rare metastatic patterns in ovarian EC. Vigilant surveillance and multimodal diagnostic approaches are crucial for accurate identification and management of recurrent disease. Similar content being viewed by others

Chen S, Lu H, Jiang S, Li M, Weng H, Zhu J, Zhang T, Wang Y, Zhao W, Wu D, Shen Z, Yang Z, Zhou Y. An analysis of clinical characteristics and prognosis of endometrioid ovarian cancer based on the SEER database and two centers in China. BMC Cancer. 2023;23:608. Ishizaka A, Taguchi A, Tsuruga T, Maruyama M, Kawata A, Miyamoto Y, Tanikawa M, Ikemura M, Sone K, Mori M, Koga K, Ushiku T, Oda K, Osuga Y. Endometrial cancer with concomitant endometriosis is highly associated with ovarian endometrioid carcinoma: a retrospective cohort study. BMC Womens Health. 2022;22:332. Nichols HB, Baird DD, DeRoo LA, Kissling GE, Sandler DP. Tubal ligation in relation to menopausal symptoms and breast cancer risk. Br J Cancer. 2013;109:1291–5. Chen S, Li Y, Qian L, Deng S, Liu L, Xiao W, Zhou Y. A review of the clinical characteristics and novel molecular subtypes of endometrioid ovarian cancer. Front Oncol. 2021;11: 668151. Shibahara K, Endo K, Ikeda T, Sakata H, Sadanaga N, Morita M, et al. Colon metastasis 20 years after the removal of ovarian cancer: report of a case. Surg Today. 2009;39:153–6. Abe K, Anzai H, Eguchi S, Ikemura M, Shinozaki-Ushiku A, Shinagawa T, Sonoda H, Yoshioka Y, Nagai Y, Abe S, Matsuzaki H, Yokoyama Y, Emoto S, Murono K, Sasaki K, Nozawa H, Ushiku T, Ishihara S. Metastasis of ovarian cancer to the descending colon. Case Rep Gastroenterol. 2023;17:129–36. Bhange SA, Bhansali M, Shaikh T, Ajgaonkar U. Colonic metastases 13 years after the primary ovarian cancer: a case study with a brief review of literature. BMJ Case Rep. 2019;12: e230127. Aqsa A, Droubi S, Amarnath S, Haddad F, Deeb L. Colorectal metastasis from ovarian neoplasm mimicking primary colon cancer. Case Rep Gastroenterol. 2021;15:41–6. Buza N. Immunohistochemistry in gynecologic carcinomas: Practical update with diagnostic and clinical considerations based on the 2020 WHO classification of tumors. Semin Diagn Pathol. 2022;39:58–77. Nasioudis D, Latif NA, Simpkins F, Cory L, Giuntoli RL 2nd, Haggerty AF, Morgan MA, Ko EM. Adjuvant chemotherapy for early stage endometrioid ovarian carcinoma: an analysis of the national cancer data base. Gynecol Oncol. 2020;156:315–9. Funding Nil. Author information Authors and Affiliations Contributions SM, AA: Writing original draft, visualization. SZ, SA: Writing—review and editing, conceptualization, visualization. This paper has been prepared by the abovementioned authors and reviewed and agreed upon for submission. The requirements for authorship as stated above in this document have been met, and that each author believes that the manuscript represents honest work. Corresponding author Ethics declarations Conflict of interest The author(s) declared no potential conflicts of interest. Ethical Approval Not applicable, because this article does not contain any studies with human or animal subjects. Consent for Publication Informed consent was sought from patient regarding participation and publication. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Malik, S., Ahuja, S., Aravind, A. et al. Recognizing Recurrent Ovarian Endometrioid Carcinoma: A Case of Malignant Sigmoid Serosa Lesion Mimicking a Mesenteric Cyst. Indian J Gynecol Oncolog 22, 92 (2024). https://doi.org/10.1007/s40944-024-00862-5 Received: Revised: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s40944-024-00862-5