Jornal de Cuidados com a Saúde da Mulher
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Synchronous Adenocarcinoma of the Ovary and Endometrium: A Case Report

Montacer Hafsi*, Marwa Moussi, Asma Zouaghi, Sarra Rihani, Faten Dridi, Souhir Najar, Smaoui Maroua, Mechaal Mourali

Introduction and importance: Synchronous occurrence of endometrial and ovarian cancers, particularly when they share the same histological type, presents diagnostic and therapeutic complexities. This case report highlights the challenges and nuances in diagnosing and managing such synchronous malignancies, emphasizing the need for meticulous evaluation and tailored therapeutic strategies.

Case presentation: A 46-year-old female (G.S) presented with chronic pelvic pain and abnormal uterine bleeding. Clinical examination revealed an enlarged uterus and masses in the left iliac fossa and ovaries. Imaging studies, including ultrasound and CT scans, indicated bilateral ovarian masses and peritoneal carcinosis. Histopathological examination following surgical intervention confirmed bilateral infiltrating grade II endometrioid adenocarcinoma involving the endometrium and ovaries.

Clinical Discussion: Synchronous endometrial and ovarian cancers, accounting for a substantial proportion of gynecological synchronous cancers, present predominantly in women around 53 years old, often affecting younger individuals with the endometrioid type. Differential diagnosis necessitates evaluating multiple clinicopathological factors to distinguish between primary tumors and metastatic disease. Recent molecular studies suggest the possibility of a continuum in these malignancies, indicating a potential origin in endometrial foci. Lynch syndrome is prevalent in a subset of cases. Treatment typically involves surgical intervention followed by neoadjuvant radiotherapy and chemotherapy.

Conclusion: The coexistence of synchronous ovarian and endometrial cancers poses diagnostic complexities that demand thorough investigation, including immunohistochemical, molecular, and genomic analysis. Accurate confirmation through targeted sequencing is crucial for tailored management strategies.