Abstract
Introduction: we present a case of ovarian metastasis from small cell lung cancer (SCLC) treated with immunotherapy-protocol in the third line chemoterapy. At present, no further seminal cases have been reported.
Case presentation: A 24 years old woman, ex-smoker, caucasian, recently pregnant, presented to the emergency room with abdominal pains; the ultrasonography showed bilateral ovarian masses. The patient underwent to right oophorectomy and left ovarian biopsy through a laparotomy approach; the 8-week pregnancy was aborted. Histological examination of the specimens showed ovarian metastasis from SCLC (TTF1+) confirmed later also with FNA of the RLL Stage IVB T1cN3M1c (Fig.1b). A first-line chemotherapy regimen (cisplatin and etoposide) was started but the patient developed diplopia. A CT scan showed a progression of the disease and the onset of a pituitary adenoma (Fig.1c) surgically removed. After second-line chemotherapy regime including cyclophosphamide, vincristine and epirubicin, there was a further increase of the lymph node station 2R and of the left ovarian metastasis (Fig.1a-1d-1e). The patient was involved in an immunotherapy-protocol (Pembrolizumab) with regression of disease.
Conclusions: The ovary is a common site of metastases from GI, breast, liver, pancreas, kidney cancers, but very rarely from a primary lung (0.3-4%). Immunotherapy could be an useful therapeutic option for treatment expecially in young patients.
- Copyright ©the authors 2017