Introduction: Although ovarian cancer incidence is lower than the cases of cancer of the uterine cervix and endometrial, the incidence of ovarian cancer is high. The mortality rate is highest among all gynecological malignancies. The patients often come for treatment at an advanced stage that has spread to the pelvis, especially to the organs such as the uterus, fallopian tubes, ovaries, and sigmoid colon through the passive spread and different hematogenous routes. This study aimed to review malignant disease in gynecologic oncology, supporting examinations and management.
Case Report: A woman, 52 years old, presented with abdominal pain one month before entering the hospital. She complained about difficulty urinating, not having a smooth bowel movement. From ultrasound examination showed an intra-abdominal mass measuring 14.3 cm x 11.2 cm x 11.1 cm, and the origin of the mass remains unclear. From contrast, pelvic CT scan showed a solid mass had spread to the uterine cervix, vagina and spread to the uterine body, infiltrated to the bladder, attached to the rectum part without intestinal obstruction, with a mass size of 7.7 cm x 7.1 cm x 16.6 cm. The procedure for this patient was an abdominal hysterectomy of total and salpingo-oophorectomy of both ovaries. The histopathology result was serious ovary adenocarcinoma.
Conclusion: The spreading of ovarian cancer is a mechanism that involves the interaction of many things, such as cancer cells from the primary tumor, which spread to the peritoneal cavity or spread hematogenously or lymphatically and enter the omentum. In this case, we had metastasis of ovarian cancer with cervical adhesions and a suspected mass in the sigmoid colon on intraoperative findings. With increasing knowledge about ovarian cancer, ovarian cancer pathogenesis, and metastases can be found and developed to treat disease and prevent spread.