Rapidly growing ovarian endometrioid adenocarcinoma involving the vagina: a case report.
OBJECTIVE
We present a rare case of a very rapidly growing stage IV ovarian endometrioid adenocarcinoma involving the uterine cervix and vagina without lymph node involvement.


METHODS
A 43-year-old woman visited the hospital with complaints of lower abdominal discomfort and vaginal bleeding over the previous 3 months. Serum levels of tumor marker CA 125 and SCC antigen (TA-4) were normal. On magnetic resonance imaging, a 7.9×9.7cm heterogeneous mass with intermediate signal intensity was observed in the posterior low body of the uterus. Two months ago, a computed tomography scan revealed an approximate 4.5×3.0cm heterogeneously enhanced subserosal mass with internal ill-defined hypodensities. A laparotomy, including a total abdominal hysterectomy with resection of the upper vagina, bilateral salpingo-oophorectomy, pelvic and para-aortic lymph node dissection, appendectomy, total omentectomy, and biopsy of rectal serosa was performed. A histological examination revealed poorly differentiated endometrioid ovarian adenocarcinoma with vaginal involvement. The patient had an uncomplicated post-operative course. After discharge, she completed six cycles of adjuvant chemotherapy with paclitaxel (175mg/m(2)) and carboplatin (300mg/m(2)) and has remained clinically disease-free until June 2010.


CONCLUSIONS
Epithelial ovarian cancer may grow very rapidly. The frequent measurement of tumor size by ultrasonography may provide important information on detection in a subset of ovarian carcinomas that develop from preexisting, detectable lesions.
Department of Obstetrics and Gynecology, Kangwon National University Medical School, Chuncheon, Korea.
Sunghun
S
Na
Jongyun
J
Hwang
Hyangah
H
Lee
Jiyeon
J
Lee
Dongheon
D
Lee
D000328:Adult; D018269:Carcinoma, Endometrioid / Q000175:diagnosis / Q000556:secondary*; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000556:secondary*; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000556:secondary*