IJG-07980; No of Pages 1 International Journal of Gynecology and Obstetrics xxx (2014) xxx
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Synchronous primary serous ovarian cancer and renal cell carcinoma Octavian G. Olaru ⁎ Department of Obstetrics and Gynecology, Bucur Maternity “St John” Clinical Hospital, University of Medicine and Pharmacy “Carol Davila,” Bucharest, Romania
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Article history: Received 5 January 2014 Received in revised form 31 March 2014 Accepted 13 May 2014 Keywords: Ovarian cancer Renal cell carcinoma
Synchronous primary ovarian cancer and renal cell carcinoma is rare, with only seven reported cases found in the literature [1–4]. A 32-year-old patient was investigated for infertility at the Bucur Maternity “St John” Clinical Hospital in Bucharest, Romania, in November 2007. A cyst measuring 4/5 cm in diameter was diagnosed on the right ovary following ultrasound examination. The patient also had bilateral distal tubal obstruction. The cyst persisted for more than six months, increasing in size, and a laparotomy was performed. Intraoperatively, a right ovarian tumor was found, which also invaded the right fallopian tube, and vegetations were found on the left ovary. No other tumors were found on the pelvic organs or peritoneum and no cancer cells were identiﬁed in the peritoneal ﬂuid. A right adnexectomy and partial resection of the left ovary were performed. Histopathology showed a grade 1 serous papillary cystadenocarcinoma of the right ovary and a borderline tumor on the left ovary. The immunohistochemical examination revealed CA 125 diffusely positive, AE1/AE3 zonal positive, S100 diffusely positive, ER positive 85%−90%, PGR positive 50%−55%, CK7 positive zonal, MUC1 diffusely positive, p53 positive 2%−3%, and Ki67 positive 10%−15%. Postoperatively, the patient started chemotherapy and was treated with two cycles of carboplatin and paclitaxel in the months that
followed. Three months after surgery, a renal mass of nearly 7 cm in diameter was discovered on the left kidney. Following a CT scan, the tumor appeared to be extended into the renal vein. A nephrectomy was performed and histopathological examination diagnosed a clear cell tubulopapillary renal cell carcinoma of Fuhrman nuclear grade II/ III (Evaluations: ovarian cancer TIIaNxM0; renal cancer stage IIIa). The patient underwent a complex treatment that included six months of interferon-alpha 2. Six- and eleven-month postoperative evaluations revealed no evidence of disease. The patient was well and had no evidence of disease 5 years later. The short amount of time between the diagnosis of ovarian cancer and the discovery of the renal tumor suggests that these were synchronous primary cancers. Synchronicity of a borderline ovarian tumor and ovarian cancer with a renal cell carcinoma in a relatively young patient is rare. The pathogenesis and the potential risk factors remain to be studied.
Conﬂict of interest The author has no conﬂicts of interest.
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http://dx.doi.org/10.1016/j.ijgo.2014.04.003 0020-7292/© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Please cite this article as: Olaru OG, Synchronous primary serous ovarian cancer and renal cell carcinoma, Int J Gynecol Obstet (2014), http://dx.doi.org/10.1016/j.ijgo.2014.04.003