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Session: ePoster: Other Neoplasia and Endoscopy 1 (Sun8)

EP325 - Rare Case Presentation of Ovarian Cancer Metastasis to the Colon

Sunday, May 11, 2025
9:22 AM - 9:27 AM PT
Location: Monitor 7, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Steven J. Capece, MD

    Fellow
    University of Texas Health at Houston
    Pearland, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    View ePoster

    • Senior Author(s)

  • MS

    Michael J. Snyder, MD, FACS

    Program Director
    University of Texas Health at Houston
    Houston, Texas, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Steven J. Capece, MD: This individual has no financial relationships with ineligible companies.
Michael J. Snyder, MD, FACS: This individual has no financial relationships with ineligible companies.
Purpose/Background: Metastasis to the colon is typically only seen in less than 1% of colon malignancies. Ovarian metastasis to the colon is a rare occurrence, typically only seen in about 6% of cases. Of the metastatic disease seen to the colon, it is typically from direct invasion or intra-peritoneal implantation. To our knowledge, there are very few cases of hematogenous spread presenting as a colonic mucosal metastatic implant of ovarian origin.

Methods/Interventions: We describe a case report of a 66 year old woman with metastatic ovarian serous carcinoma. She initially presented with a left lower abdominal mass, found to be a 13 cm complex left adnexal lesion. Her last colonoscopy was in 2021 and she was recommended to have a repeat one. She was found to have a 5 cm mucosal lesion in the sigmoid colon on colonoscopy which was positive for ovarian metastasis. She initially was treated with chemotherapy followed by planned surgery. She underwent joint case with Gynecology-Oncology and Colorectal Surgery for an open hysterectomy, bilateral salpingoopherectomy, and segmentectomy of the involved sigmoid colon.

Results/Outcomes: Patient tolerated the procedure well and was discharged by post-operative day 3 after return of bowel function. She was seen in office on post-op day 14, doing well. Her final pathology showed high grade serous carcinoma with associated mucosal ulceration, five negative lymph nodes.

Conclusion/Discussion: We describe a rare occurrence of hematogenous spread to the colon seen as a mucosal metastatic implant in the sigmoid colon. Although metastasis to the colon from the ovary is possible, it is typically seen as a direct implant. Additionally, final pathology revealed no other evidence of metastatic disease from the multiple other biopsies and specimens. Ongoing surveillance and screening colonoscopy will be a core part of her ongoing treatment pathway. As of now, no other metastatic disease has been found. She is planned to continue on niraparib as per medical oncology.

Colonoscopy
Colonoscopy showing metastatic lesion in sigmoid colon (biopsy positive for serous carcinoma of ovarian origin)

MRI
MRI showing complex pelvic mass, serous carcinoma