The role of prophylactic bilateral oophorectomy at the time of initial diagnosis of a unilateral ovarian metastasis in cases with colorectal adenocarcinoma.
OBJECTIVE
In cases with a macroscopic unilateral ovarian metastasis of colorectal adenocarcinoma, a clear therapeutic policy regarding a prophylactic bilateral oophorectomy is lacking.


METHODS
Four cases of ovarian metastases of colorectal adenocarcinoma are presented.


RESULTS
Case 1 is a 63-year-old with ascending colon carcinoma, Dukes' C, and right oophorectomy due to metachronous ovarian metastasis. Case 2 is a 28-year-old with transverse colon carcinoma, Dukes' D, and right oophorectomy due to synchronous ovarian metastasis. Case 3 is a 40-year-old with rectal carcinoma, Dukes' B, and right oophorectomy due to metachronous ovarian metastasis. Case 4 is a 32-year-old with rectal carcinoma, Dukes' D, and bilateral oophorectomy due to synchronous and metachronous ovarian metastases. Later, in cases 1 and 3, in which a unilateral ovary was preserved, ovarian metastases to the preserved ovary were found and caused severe clinical symptoms. However, by that time their general condition did not permit any additional laparotomy.


CONCLUSIONS
Without other extensive metastases, if demonstrable diseases are found in a unilateral ovary, a prophylactic bilateral oophorectomy is recommended.
Yamaguchi
Tetsuya
T
Department of Surgery, Rakuwakai-Otowa Hospital, Kyoto, Japan. rakuwadr011@rakuwadr.com
Takahashi
Hiroshi
H
Kagawa
Ryuzaburo
R
Takeda
Ryoji
R
Sakata
Shingo
S
Yamamoto
Michihiro
M
Nishizaki
Daisuke
D
Iwasa
Yoko
Y
D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*