Huge ovarian metastasis from jejunal cancer occurring immediately after initial operation

Correct preoperative diagnosis of jejunal cancer is difficult, and there are no clear guidelines for the postoperative follow-up to monitor the recurrence of jejunal cancer. This report describes asynchronous ovarian metastasis from jejunal cancer occurring after initial operation. The patient was a 68-year-old postmenopausal woman with a preoperatively correctly diagnosed jejunal cancer. Partial resection of the jejunum with regional lymph node dissection was performed, with both ovaries intact at the first operation. Three months later, vaginal bleeding and a large metastasis in the left ovary were detected, for which a left oophorectomy was performed. Peritoneal dissemination was also detected perioperatively, so that chemotherapy with 5-FU/leukovoline was started. The patient is still alive more than 12 months after the most recent operation. Our case demonstrates that it is necessary to pay careful attention to synchronous or non-synchronous metastases to the ovaries after operation for jejunal cancer in females. Consideration should also be given to the efficacy of oophorectomy for ovarian metastases and of intensive chemotherapy combined with jejunal resection for carcinoma because of the poor prognosis of these treatment modalities.