Unusual recurrence of ovarian carcinoma 9 years after initial diagnosis

Ovarian carcinomas typically metastasize to multiple sites via exfoliation, lymphatic spread, or direct invasion. Gastrointestinal tract involvement i s usually the result of exfoliation with direct invasion of tumor within th e mesentery or through serosal surfaces. We present a case of late recurren ce of ovarian carcinoma isolated to the sigmoid mucosa, heralded only by br ief left lower quadrant pain with hematochezia in a patient otherwise disea se free for 9 years. This unusual presentation illustrates the therapeutic dilemma faced by clinicians when a tumor is of uncertain origin and undersc ores the need for continued follow-up and close scrutiny of new symptoms in patients with stage I disease and for those who enjoy prolonged disease-fr ee intervals. (C) 1999 Academic Press.