Case report
Ovarian metastases as a first symptom of small cell lung cancer

This is an analysis of the case of a 46-year-old woman suffering from ovarian metastases of small cell lung cancer. The main symptoms were abdominal pain, vaginal bleeding and weight loss. The ovarian tumor was detected during computed tomography (CT) of the abdominal cavity. X-rays and CT of the chest revealed enlarged mediastinal lymph nodes and a tumor in the right lung. As a result of constant bleeding from the genital tract a total hysterectomy was performed. A histopathological examination of the ovarian tumor confirmed the presence of small cell cancer, most likely as a lung metastasis. Head CT revealed a metastasis in the left parietal lobe. Subsequently, on the basis of the results of immunohistochemical examinations, small cell lung cancer was explicitly confirmed. The patient received four chemotherapy cycles with cisplatin, etoposide and palliative radiotherapy for the lung and brain cancer. Both partial remission and improved clinical status were obtained. Three months later the disease progressed (lung tumor enlargement and numerous brain metastases) and the general condition of the patient deteriorated. Second line chemotherapy was applied at this time. The patient received four cycles with topotecan according to the scheme. The chemotherapy gave unsatisfactory results and was therefore stopped in favor of palliative treatment.