September 2020 · Volume 9 · Issue 9 Page 3889
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Yadav R et al. Int J Reprod Contracept Obstet Gynecol. 2020 Sep;9(9):3889-3891
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Case Report
Synchronous endometrial and ovarian cancer: a rare presentation
Reena Yadav, Nishtha Jaiswal*, Ruby Yadav, Manisha Kumar
INTRODUCTION
Synchronous primary tumor account for 0.5-1.7 % of all
gynecological malignancies.
1
The most common 40%-
53% synchronous primary tumors of genital tract are
ovarian and endometrial cancers.
2
Patients with synchronous endometrioid tumors of
endometrium and ovary are generally younger, have low
grade malignancy, and prognosis is better than other
histologic types.
3-5
It is challenging diagnostically and therapeutically when
there is similar histology.
CASE REPORT
A 38-year-old nulliparous woman presented with chief
complain of irregular and prolonged bleeding of four
months duration. She was obese with BMI 40 kg/m
2
. She
was detected with hypothyroidism twenty years back,
was hypertensive since 4 years and was recently
diagnosed with diabetes mellitus. There was no history of
white discharge per vaginum, hormonal pill intake,
weight loss and bladder or bowel complaints. On
abdominal examination a mass corresponding to 16-week
size of uterus was felt. Vaginal examination suggested
the mass was in the right adnexa with bulky uterus. The
MRI report showed a well-defined, lobulated complex,
solid cystic multiseptated mass measuring 8.8×7.7×8.8
cm in the right adnexa, and the uterus was bulky with
indistinct endo-myometrial junction, with the left ovary
visualized and normal. Endometrial biopsy was taken and
histopathological examination was reported as
endometrial adenocarcinoma. Amongst tumor markers
CA 125 was 212.7U/l. Considering both ovarian and
uterine malignancy with an unclear primary tumor, an
exploratory laparotomy with peritoneal cytology, total
abdominal hysterectomy, bilateral salpingo-
oopherectomy, infracolic omentectomy and pelvic
lymphadenectomy was performed. Intraoperatively the
uterus was 6 to 8 weeks size and there was a 10×10 cm
solid cystic mass arising from right ovary. The ascitic
fluid cytology was negative for malignant cells.
ABSTRACT
Synchronous primary cancers are relatively uncommon in the general population. About 0.5 -1.7% of gynecological
malignancies have synchronous primary cancer of female genital tract. Amongst the synchronous gynecological
malignancies synchronous endometrioid carcinoma is most common and has good prognosis. Patients with
synchronous endometrioid tumors of endometrium and ovary are usually younger, have low grade number, and their
prognosis is better than other histologic types. The authors are presenting a case of 38 years old nulliparous obese
woman with pain in abdomen and heavy menstrual bleeding for a duration of four months. The MRI pelvis was
suggestive of well defined, lobulated, complex, solid cystic multiseptated lesion measuring 8.8×7.7×8.8 cm in right
adnexa, with anteverted uterus, and a bulky indistinct emdomyometrial junction. Histopathology revealed
synchronous endometrial carcinoma of both uterus and ovary.
Keywords: Endometrial cancer, Ovarian cancer, Synchronous tumors
Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India
Received: 06 July 2020
Accepted: 05 August 2020
*Correspondence:
Dr. Nishtha Jaiswal,
E-mail: nishtha.amu@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203877