J Gastric Cancer.  2015 Sep;15(3):218-221. 10.5230/jgc.2015.15.3.218.

Improved Survival of a Patient with Gastric and Other Multiple Metastases from Ovarian Cancer by Multimodal Treatment: A Case Report

• Hwangbo S
• Kwon OK
• Chung HY
• Yu W

• KMID: 2372209
• DOI: http://doi.org/10.5230/jgc.2015.15.3.218

Abstract

Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.

Keyword

Gastric metastasis; Ovarian neoplasms; Combined modality therapy

MeSH Terms

Adenocarcinoma
Aged
Combined Modality Therapy*
Diagnosis
Drug Therapy
Dyspepsia
Endoscopy, Digestive System
Female
Gastrectomy
Gastroenterostomy
Humans
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis*
Ovarian Neoplasms*
Pathology
Prognosis
Pyloric Antrum
Recurrence
Stomach

Figure

• 

  Fig. 1 Computed tomography scan of the metastatic tumor. The computed tomography scan shows a 6.5×6.0-cm mass compressing the gastric antrum and body, suggestive of a metastatic node of the omentum.

• 

  Fig. 2 Gross photograph of the stomach mass. (A) The resected stomach has a protruding tumor that measures 7×5-cm with central ulceration. (B) On the cut section, this white-yellow tumor is situated in the muscularis propria, and bulges into the serosa.

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  Fig. 3 Recurrence in the remnant stomach. (A) 18F-fluorodeoxyglucose positron emission tomography with computed tomography shows a hypermetabolic mass in the remnant stomach. (B) An enhanced abdominal computed tomography demonstrates recurrent gastric cancer with invasion to the pancreas. (C) On esophagogastroduodenoscopy, a normal mucosal covered mass is visible at the proximal site of the anastomosis.

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