Poorly Differentiated Ovarian Adenocarcinoma Developing in a Case of Well-Differentiated Endometrioid Carcinoma of the Contralateral Ovary

Abstract

Abstract

Background: Endometrioid carcinoma and undifferentiated carcinoma in the ovary have not been reported together or in the same patient. Case: The case of a young woman who developed undifferentiated carcinoma ovary within 3 months of contralateral adnexectomy for well-differentiated endometrioid carcinoma stage I is presented. The probable etiopathogenesis and management are discussed. Total hysterectomy, right adnexectomy, and infracolic omentectomy with peritoneal sampling were performed. There was no grossly apparent residual disease and histology revealed a poorly differentiated ovarian adenocarcinoma and metastatic implants on the uterus and omentum. Combination chemotherapy was given. Results: The patient was disease free after 6 months. Conclusions: Both kinds of epithelial malignancies arose independently. A possible molecular mechanism could be operating at the genetic level to predispose women with low-grade epithelial tumors of low malignant potential to develop other epithelial tumors of high malignant potential. A high index of suspicion and careful follow-up for development of malignancy in the remaining gonad after conservative surgery for endometrioid ovarian malignancy are recommended. (J GYNECOL SURG 27:159)