Long survival after ovarian and hepatic metastasis from carcinoma of the large bowel: report of a case.

Herein we present the case of a woman who is now 19 years post abdominoperineal resection for a Dukes' C1 rectal carcinoma, 10 years post right hemicolectomy for a Duke's C1 carcinoma of the ascending colon and removal of a solitary hepatic metastasis and now 9 years post resection of an ovarian metastasis. She had 5-fluoracil, postoperatively. This is the ninth case reported in the literature of a 5-year survivor free of disease following oophorectomy for metastatic adenocarcinoma of the large bowel. The finding of ovarian and hepatic metastases from her colorectal carcinoma would have indicated a poor prognosis. We feel that those rare patients who have an unexpected long survival should be reported for accumulation of clinical data, illustration of their clinical management, and analyses of the applied therapeutic interventions.

Adenocarcinoma of the colon masquerading as primary ovarian neoplasia. An analysis of ten cases.

This paper reviews the clinical characteristics of a group of patients in whom unsuspected primary adenocarcinoma of the colon presented with signs and symptoms of a primary ovarian neoplasia. In most patients, the ovaries were removed, the correct diagnosis was established at a later time, and a second surgery for resection of the primary adenocarcinoma of the colon was then performed. Preoperative use of colonoscopy or barium-enema examination would have helped. We compared these patients to a group of patients with similar clinical characteristics, but in whom the ovarian metastases were clinically apparent months after the resection of a primary colorectal cancer. We found that, in both groups, age of the patients, anatomic distribution of the primary tumor, histologic differentiation, serosal or mesenteric lymph node tumor involvement, and timing of the oophorectomy in relationship to removal of the primary colorectal tumor did not affect the overall survival. Once ovarian metastases were documented, patients died regardless of treatment, approximately 16 1/2 months after the diagnosis.