Dear Editor:
Ovarian carcinoma is the most lethal gynecological cancer [1], and the endometrioid type accounts for 7–20 % of all cases [2]. The gastrointestinal stromal tumor (GIST) may mimic ovarian tumors, as reported previously by other authors [3, 4]. We present a case report of a GIST mimicking an ovarian carcinoma.
A 67-year-old female underwent a colonoscopy for colon cancer screening. It showed a submucosal lesion, covered with normal appearance mucosa. An endoscopic ultrasonography showed between 4 and 14 cm from the anal margin, with the greatest transverse diameter of 42.5 by 32.7 mm, a heterogeneous lesion, hypoechoic, with slightly irregular borders, originated in the muscular layer; the luminal board counter presented itself closely adjacent to an ovary, where it was identified as a cystic lesion, and a loss of the cleavage plane. We identified a perilesional, oval, hypoechoic adenopathy, with a diameter of 11 by 5.2 mm. We suspected of a GIST or an extraintestinal tumor involving the rectum. An endoscopic ultrasonography (EUS) with fine needle (19G) aspiration with collection of sampling for histology and cytology revealed high-grade undifferentiated neoplasm suggestive of ovarian carcinoma, CD117 negative.
She underwent a surgery that confirmed an endometrioid ovarian carcinoma, invading the rectum. Subsequently, the patient has started chemotherapy with carboplatin and paclitaxel and is still on treatment.
Besides, there have been reported a case of primary epithelial ovarian carcinoma with gastric metastasis mimicking GIST, but to our best knowledge, there have not been reported an ovarian cancer mimicking a rectal GIST.
We emphasize the high accuracy of EUS in the correct characterization of the lesion and its anatomical relations and the possibility of collecting a sample that confirms the diagnosis, allowing a more guided surgery.
References
Ferlay J, Shin HR, Bray F et al (2010) GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide IARC CancerBase No. 10. International Agency for Research on Cancer, Lyon
Cho KR, Shih I-M (2010) Ovarian Cancer, Annu Rev Pathol. PMC Jan 1
Belics Z, Csapo Z, Szabo I, Papay J, Szabo J, Papp Z (2003) Large gastrointestinal stromal tumor presenting as an ovarian tumor. A case report. J Reprod Med 48:655–658
Carlomagno G, Beneduce P (2004) A gastrointestinal stromal tumor (GIST) masquerading as an ovarian mass. World J Surg Oncol 2:15
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Araújo, T., Castro-Poças, F., Santos, M. et al. Endoscopic ultrasound, GIST, and ovarian cancer. Int J Colorectal Dis 30, 991 (2015). https://doi.org/10.1007/s00384-014-2083-8
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DOI: https://doi.org/10.1007/s00384-014-2083-8