Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2021; 9(11): 2533-2541
Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2533
Gastrointestinal-type chemotherapy prolongs survival in an atypical primary ovarian mucinous carcinoma: A case report
Qi Wang, Xiao-Yan Niu, Hui Feng, Jie Wu, Wen Gao, Zai-Xian Zhang, Yu-Wei Zou, Bi-Yuan Zhang, Hai-Ji Wang
Qi Wang, Hui Feng, Wen Gao, Bi-Yuan Zhang, Hai-Ji Wang, Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Xiao-Yan Niu, Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Jie Wu, Yu-Wei Zou, Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Zai-Xian Zhang, Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Author contributions: Wang Q wrote the paper; Wu J, Zou YW, and Gao W performed the pathological tests; Zhang ZX, Niu XY, Feng H, and Zhang BY interpreted the imaging examinations; Wang Q and Wang HJ provided this case.
Supported by Natural Science Foundation of Shandong Province, No. ZR2018BH019.
Informed consent statement: The present study was approved by the Affiliated Hospital of Qingdao University. The specimens of this study were obtained from pathology department of the Affiliated Hospital of Qingdao University. Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Ji Wang, MD, Doctor, Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266000, Shandong Province, China. whj_qdfy@163.com
Received: September 8, 2020
Peer-review started: September 8, 2020
First decision: December 8, 2020
Revised: December 16, 2020
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: April 16, 2021
Abstract
BACKGROUND

Primary ovarian mucinous carcinoma is a rare histologic subtype of epithelial ovarian carcinoma and exhibits considerable morphologic overlap with secondary tumour. It is hard to differentiate primary from metastatic ovarian mucinous carcinoma by morphological and immunohistochemical features. Because of the histologic similarity between primary ovarian mucinous carcinoma and metastatic gastrointestinal carcinoma, it has been hypothesized that ovarian mucinous carcinomas might respond better to non-gynecologic regimens. However, the standard treatment of advanced ovarian mucinous carcinoma has not reached a consensus.

CASE SUMMARY

A 56-year-old postmenopausal woman presented with repeated pain attacks in the right lower quadrant abdomen, accompanied by diarrhoea, anorexia, and weight loss for about 3 mo. The patient initially misdiagnosed as having gastrointestinal carcinoma because of similar pathological features. Based on the physical examination, tumour markers, imaging tests, and genetic tests, the patient was clinically diagnosed with ovary mucinous adenocarcinoma. Whether gastrointestinal-type chemotherapy or gynecologic chemotherapy was a favourable choice for patients with advanced ovarian mucinous cancer had not been determined. The patient received a chemotherapy regimen based on the histologic characteristics rather than the tumour origin. The patient received nine cycles of FOLFOX and bevacizumab. This was followed by seven cycles of bevacizumab maintenance therapy for 9 mo. Satisfactory therapeutic efficacy was achieved.

CONCLUSION

The genetic analysis might be used in the differential diagnosis of primary ovarian mucinous carcinoma and non-gynecologic mucinous carcinoma. Moreover, primary ovarian mucinous carcinoma patients could benefit from gastrointestinal-type chemotherapy.

Keywords: Ovarian mucinous cancer, Chemotherapy, Pathology, Next-generation sequencing, Case report

Core Tip: Primary ovarian mucinous carcinoma is a rare histologic subtype of epithelial ovarian carcinoma and exhibits considerable morphologic overlap with secondary tumour. Because of the histologic similarity between primary ovarian mucinous carcinoma and metastatic gastrointestinal carcinoma, it has been hypothesized that ovarian mucinous carcinomas might respond better to non-gynecologic regimens. Here, we report an initially misdiagnosed case of primary ovarian mucinous carcinoma by considering clinical characteristics, imaging, and genetic tests. The patient received a chemotherapy regimen based on the histologic characteristics rather than the tumour origin. This achieved satisfactory therapeutic efficacy.