A 14-year follow-up of malignant mesenchymal mixed ovarian tumor with rare colon enteral metastases after postoperative adjuvant chemotherapy: A case report

Abstract Background: Ovarian malignant mesenchymal mixed tumor (MMMT) is a malignant tumor composed of highly malignant epithelium and mesenchymal components. These tumors have a very high degree of malignancy and poor prognosis. Ovarian MMMTs metastasize mostly to the abdomen and distant organs. This report describes a patient with a rare colon enteral metastasis of ovarian MMMT who has survived for more than 14 years.Case Report: A 54-year-old Chinese woman was diagnosed with ovarian MMMT in 2007 and underwent radical ovarian surgery, followed by ten cycles of adjuvant chemotherapy with paclitaxel and carboplatin. In 2014, the patient's serum CA125 had increased to 104.92 U/mL, and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) showed an abnormal increase in local nodular FDG in the ascending colon. A pathological biopsy obtained during colonoscopy suggested an adenocarcinoma, for which she underwent radical colon resection. Postoperative pathologic examination confirmed that the lesion was an enteral metastasis of ovarian MMMT in the ascending colon. The patient underwent eight cycles of adjuvant chemotherapy, consisting of docetaxel and carboplatin. Her physical, psychological and social functions were completely restored. The patient has survived for more than 14 years since the original surgery and over 7 years since the diagnosis of metastasis, and her prognosis is good.Conclusions: Findings in this patient suggest that intestinal metastases of ovarian MMMT not only involve extracteral implantation, but can gradually infiltrate into the blood and spread to other organs. Primary or secondary tumors can be excluded based on each patient's tumor-related history.