title: Challenging diagnosis of a jejunal adenocarcinoma with ovarian metastasis: report of an unusual case.
abstract: We report the first documented case of ovarian metastasis from a jejunal primary adenocarcinoma in an Australian patient. The presentation was unusual, initially a suspicious abdominal nodule in the epigastric area, which turned out to be an adenocarcinoma of possible intestinal origin. Gastroscopy and colonoscopy were performed with no suspicious lesion identified. Abdominal and pelvic ultrasound imaging showed a complex pelvic mass suspicious of ovarian cancer. Laparoscopy was performed to exclude possibility of ovarian cancer and small bowel cancer. The ovarian mass showed similar features from the epigastric nodule, again suggestive of intestinal primary. Definitive diagnosis was obtained when the patient represented 2 months later with malignant bowel obstruction requiring palliative resection of the proximal jejunum. This case demonstrates the difficulty in diagnosing ovarian metastasis from a small bowel primary, which has the potential to mimic an ovarian primary tumour clinically, and a large bowel or ovarian primary pathologically.
authors.affiliation: Royal Perth Hospital, Perth, Western Australia, Australia. theyangyangh@gmail.com
authors.forename: Yang Yang
authors.initials: YY
authors.lastname: Huang
authors.forename: Jeremy John
authors.initials: JJ
authors.lastname: Pratt
authors.forename: Marcus
authors.initials: M
authors.lastname: Dabner
authors.forename: William
authors.initials: W
authors.lastname: Tjhin
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007580:Jejunal Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor