Abstract
Purpose
To present a case of very late (more than 20 years) recurrence of epithelial ovarian carcinoma and to review the pertinent literature. We encountered a 50-year-old patient who, at the age of 22, underwent cytoreductive surgery and adjuvant chemotherapy for stage III serous ovarian carcinoma. She recurred after 28 years and underwent secondary surgery and chemotherapy.
Method
A PubMed search of the English literature containing the following key words: ovarian cancer, late recurrence, late relapse, late metastasis was performed.
Results
Only five cases (including the present one) with recurrence after more than 20 years are so far on record. Of these, four patients were 33 years old or younger and had advanced stage at diagnosis. Time to recurrence ranged from 21 to 28 years. All patients had serous carcinoma and three had recurrence in lymph nodes.
Conclusions
Very late recurrence is an extremely rare event and may result from either regrowth of dormant tumor cells or from development of a new cancer. Lifelong follow-up is critically important for ovarian cancer patients.
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References
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. 55:74
Ozols RF (2006) Systemic therapy for ovarian cancer: current status and new treatments. Semin Oncol 33(2 Suppl 6):S3–S11
Dowdy SC, Pfeifer EA, Longcope DC, Cliby WA (1999) Unusual recurrence of ovarian carcinoma 9 years after initial diagnosis. Gynecol Oncol 74:495–498
Bamias A, Efstathiou E, Vassilakopoulou M, Koutsoukou V, Papadimitriu C, Rodolakis A et al (2005) Late relapse of epithelial ovarian cancer: a single institution experience. Eur J Gynaecol Oncol 26:439–442
Sahdev A, Hughes JH, Barwick T, Rockall AG, Gallagher CJ, Reznek RH (2007) Computed tomography features of recurrent ovarian carcinoma according to time to relapse. Acta Radiol 48:1038–1044
Testelmans D, Van Raemdonck D, Amant F, De Wever W, Verbeken E, Nackaerts K (2010) Late recurrent ovarian carcinoma metastatic to the thoracic wall. Acta Clin Belg 65:354–356
Zylberberg B, Dormont D, Madelenat P, Daraï E (2004) Relapse after more than 20 years of follow-up for epithelial ovarian carcinoma. Obstet Gynecol 103:1082–1084
Buller RE, Skilling JS, Sood AK, Plaxe S, Baergen RN, Lager DJ (1998) Field cancerization: why late “recurrent” ovarian cancer is not recurrent. Am J Obstet Gynecol 178:641–649
Jacobs IJ, Kohler MF, Wiseman RW, Marks JR, Whitaker R, Kerns BAJ et al (1992) Clonal origin of epithelial ovarian carcinoma: analysis by loss of heterozygosity, p53 mutation, and X-chromosome inactivation. J Natl Cancer Inst 84:1793–1798
Ruppender NS, Morrissey C, Lange PH, Vessella RL (2013) Dormency in solid Tumors implication for prostate cancer. Cancer Metastasis Rev 32:501–509
Hedley BD, Chambers AF (2009) Tumor dormancy and metastasis. Adv Cancer Res 102:67–101
Winquist RJ, Boucher DM, Wood M, Furey BF (2009) Targeting cancer stem cells for more effective therapies: taking out cancer’s locomotive engine. Biochem Pharmacol 78:326–334
Tomao F, Papa A, Strudel M, Rossi L, Lo Russo G, Benedetti Panici P et al (2014) Investigating molecular profiles of ovarian cancer: an update on cancer stem cells. J Cancer 5:301–310
Murphy SK (2010) Targeting ovarian cancer-initiating cells. Anticancer Agents Med Chem 10:157–163
Zhou B-BS, Zhang H, Damelin M, Geles KG, Grindley JC, Dirks PB (2009) Tumour initiating cells: challenges and opportunities for anticancer drug discovery. Nat Rev Drug Discov 8:806–823
Zhang S, Balch C, Chan MW, Lai HC, Matei D, Schilder JM et al (2008) Identification and characterization of ovarian cancer Initiating cells from primary human tumors. Cancer Res 68:4311–4320
Vang R, Shih IeM, Kurman RJ (2009) Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. Adv Anat Pathol 16:267–282
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Menczer, J., Schreiber, L., Peled, O. et al. Very late recurrence (after more than 20 years) of epithelial ovarian carcinoma: case report and literature review. Arch Gynecol Obstet 291, 1199–1203 (2015). https://doi.org/10.1007/s00404-014-3597-6
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DOI: https://doi.org/10.1007/s00404-014-3597-6