Perforation of a malignant ovarian tumor into the recto-sigmoid colon.
Ovarian cancer often presents at an advanced stage, but tends to be an intra-peritoneal disease that respects peritoneal planes. Thus, colo-rectal perforation of the tumor is an extremely rare presentation. The surgical treatment of malignant colo-ovarian fistula should include complete cyto-reduction at the same time as the treatment of the fistula. However, prognosis remains poor, because of the advanced stage of neoplasia. We report the case of a patient with an ovarian malignant tumor perforating into the recto-sigmoid colon. CT scan was the cornerstone of the radiological diagnosis. We managed to perform a complete cyto-reduction, including an en-bloc resection of the uterus, the mass, adnexa and recto-sigmoid with removal of the associated pelvic abscess.
Bats
Anne-Sophie
AS
Department of Gynaecological Oncology, St Bartholomew's Hospital, West Smithfield, London, UK. Anne-Sophie.Bats-Mongardon@bartsandthelondon.nhs.uk
Rockall
Andrea G
AG
Singh
Naveena
N
Reznek
Rodney H
RH
Jeyarajah
Arjun
A
D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed