An unusual manifestation of clear cell carcinoma – case report

• Authors: Aleksandra Buczek-Kutermak , Wojciech M. Szanecki , Anna Jabłońska , Agnieszka M. Witkowska , Michał Palowski , Andrzej Witek

Title variants

PL

Niezwykły objaw raka jasnokomórkowego – opis przypadku

• Languages of publication: EN PL

Abstracts

EN

The metabolism of neoplastic cells is perceived as the cause of atherothrombotic incidents in cancers since the 19th century. Those incidents occur in 1–11% cancer cases. In clear cell carcinoma, accounting for 5% of ovarian cancers, atherothrombotic incidents tend to occur 2.5 times more frequently. Clear cell carcinoma is diagnosed earlier and at a younger age compared to other ovarian cancers. The cancer is also characterized by drug resistance to standard treatment. A 47-year-old patient was admitted to the Department of Gynaecology and Obstetrics of School of Medicine in Katowice to treat a tumor of the right ovary. The tumor was detected a month before during the diagnostics of an ischemic stroke which occurred despite no risk factors being present. A laparotomy was performed and the tumor, left adnexa and uterus were removed, according to ovarian cancer protocol. Histopathological examination confirmed the diagnosis of adenocarcinoma clarocellulare (clear cell carcinoma – CCC). The patient was referred for further oncological treatment on 5th day after surgery. Oncological alertness needs to be maintained in cases of unexplained atherothrombotic incidents. An interdisciplinary approach can improve patients’ prognosis by diagnosing the cancer earlier.

PL

Choroba nowotworowa już od dawna uznawana jest za przyczynę incydentów zakrzepowo-zatorowych. Incydenty te występują w 1–11% przypadków raków. W raku jasnokomórkowym, który stanowi około 5% nowotworów złośliwych jajnika, incydenty zakrzepowo-zatorowe występują 2,5 razy częściej niż w innych typach histologicznych. Rak jasnokomórkowy jest rozpoznawany u młodszych kobiet i we wcześniejszym stadium. Nowotwór cechuje też chemiooporność na standardowe leczenie. Kobieta 47-letnia została przyjęta do Kliniki Ginekologii i Położnictwa Wydziału Lekarskiego w Katowicach w celu leczenia guza (raka) przydatków prawych, którego wykryto miesiąc wcześniej w trakcie diagnostyki udaru niedokrwiennego. Udar wystąpił mimo braku czynników obciążających. Wykonano laparotomię według protokołu raka jajnika. Badanie histopatologiczne potwierdziło rozpoznanie: rak jasnokomórkowy (clear cell carcinoma – CCC). Pacjentkę w 5 dobie po operacji wypisano ze szpitala i skierowano do dalszego leczenia onkologicznego. Interdyscyplinarne podejście zespołu lekarskiego może poprawić rokowanie pacjentek przez wcześniejsze wykrycie nowotworu. Należy zachować czujność onkologiczną w przypadku niewyjaśnionego incydentu zakrzepowo-zatorowego.

Keywords

EN

atherothrombotic incident; clear cell carcinoma; incydent zakrzepowo-zatorowy; ovarian cancer; rak jajnika; rak jasnokomórkowy jajnika; stroke; udar

Discipline

• MEDICINE: MEDICINE

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2018
• Issue: 72
• Pages: 257–260

Contributors

author

Aleksandra Buczek-Kutermak

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

author

Wojciech M. Szanecki

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

author

Anna Jabłońska

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

author

Agnieszka M. Witkowska

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

author

Michał Palowski

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

author

Andrzej Witek

• Department of Gynaecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland

References

• 1. Matsuura Y., Robertson G., Marsden D.E., Kim S.N., Gebski V., Hacker N.F. Thromboembolic complications in patients with clear cell carcinoma of the ovary. Gynecol. Oncol. 2007; 104(2): 406–410.
• 2. Kaur S., Kerkar R.A., Maheshwari A., Shylasree T.S., Gupta S., Deodhar K. Clinical characteristics with patterns of relapse and survival analysis of ovarian clear cell carcinoma. Indian J. Cancer 2016; 53(2): 288–291, doi: 10.4103/0019-509X.197719.
• 3. Mizuno M., Kikkawa F., Shibata K., Kajiyama H., Ino K., Kawai M., Nagasaka T., Nomura S. Long-Term Follow-Up and Prognostic Factor Analysis in Clear Cell Adenocarcinoma of the Ovary. J. Surg. Oncol. 2006; 94(2): 138–143.
• 4. Chan J.K, Teoh D., Hu J.M., Shin J.Y., Osann K., Kapp D.S. Do clear cell ovarian carcinomas have poorer prognosis compared to other epithelial cell types? A study of 1411 clear cell ovarian cancers. Gynecol. Oncol. 2008; 109(3): 370–376, doi: 10.1016/j.ygyno.2008.02.006.
• 5. Kim S.J., Kimoto Y., Nakamura H., Taguchi T., Tanji Y., Izukura M., Shiba E., Takai S. Ovarian Carcinoma with Fistula Formation to the Sigmoid Colon and Ileum: Report of a Case. Surg. Today 1999; 29(5): 449–452.
• 6. Duska L.R., Garrett L., Henretta M., Ferriss J.S., Lee L., Horowitz N. When ‘never-events’ occur despite adherence to clinical guidelines: The case of venous thromboembolism in clear cell cancer of the ovary compared with other epithelial histologic subtypes. Gynecol. Oncol. 2010; 116(3): 374–377, doi: 10.1016/j.ygyno.2009.10.069.
• 7. Kuan A.S., Teng C.J., Wu H.H., Su V.Y., Chen Y.T., Chien S.H., Yeh C.M., Hu L.Y., Chen T.J., Tzeng C.H., Liu C.J. Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study. BMC Med. 2014; 12: 53, doi: 10.1186/1741-7015-12-53.
• 8. Dearborn J.L., Urrutia V.C., Zeiler S.R. Stroke and Cancer- A Compli-cated Relationship. J. Neurol. Transl. Neurosci. 2014; 2(1): 1039.
• 9. Kim S.G., Hong J.M., Kim H.Y., Lee J., Chung P.W., Park K.Y., Kim G.M., Lee K.H., Chung C.S., Bang O.Y. Ischemic Stroke in Cancer Patients With and Without Conventional Mechanisms: A Multicenter Study in Korea. Stroke 2010; 41(4): 798–801, doi: 10.1161/STROKEAHA.109.571356.
• 10. Schwarzbach C.J., Schaefer A., Ebert A., Held V., Bolognese M., Kablau M., Hennerici M.G., Fatar M. Stroke and Cancer: The Importance of Cancer-Associated Hypercoagulation as a Possible Stroke Etiology. Stroke 2012; 43(11): 3029–3034, doi: 10.1161/STROKEAHA.112.658625.
• 11. O'Brien M.E., Schofield J.B., Tan S., Fryatt I., Fisher C., Wiltshaw E. Clear cell epithelial ovarian cancer (mesonephroid): bad prognosis only in early stages. Gynecol. Oncol. 1993; 49(2): 250–254.
• 12. Goff B.A., Sainz de la Cuesta R., Muntz H.G., Fleischhacker D., Ek M., Rice L.W., Nikrui N., Tamimi H.K., Cain J.M., Greer B.E., Fuller A.F. Jr. Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol. Oncol. 1996; 60(3): 412–417.

• Document Type: article