Preoperative Diagnosis of Small Bowel Metastasis of Ovarian Clear Cell Carcinoma Using Capsule and Double-Balloon...

We present a rare case of small bowel metastasis of ovarian clear cell carcinoma, successfully diagnosed preoperatively using capsule and double-balloon endoscopy. The patient was a 62-year-old woman who underwent primary surgery for stage IIB ovarian clear cell carcinoma followed by six cycles of adjuvant chemotherapy. Six years later, she developed iron-deficiency anemia with melena, but conventional upper and lower endoscopy failed to identify the source of bleeding. Subsequent capsule endoscopy revealed a tumor in the distal ileum, and a biopsy was taken using double-balloon endoscopy. Pathological and immunohistochemical findings supported a diagnosis of recurrent ovarian clear cell carcinoma. Surgical resection was performed, followed by chemotherapy, and the patient remains recurrence-free. This is the first case of small bowel metastasis of ovarian clear cell carcinoma diagnosed preoperatively with endoscopic biopsy. It highlights the criticality of advanced endoscopic modalities for evaluating unexplained anemia in patients with a history of ovarian cancer.