Abstract
INTRODUCTION: Ovarian cancer remains a leading cause of cancer-related mortality. Although the peritoneum and abdominal lymph nodes are the most common sites of metastasis, duodenal metastasis is extremely rare. We report a rare case of duodenal metastasis from ovarian clear cell carcinoma (OCCC) that initially presented with gastrointestinal bleeding and was successfully treated with curative resection. CASE PRESENTATION: A 52-year-old woman with a history of OCCC (International Federation of Gynecology and Obstetrics stage IIA) underwent total hysterectomy with bilateral salpingo-oophorectomy and partial omentectomy, followed by adjuvant platinum-based chemotherapy. During follow-up, routine blood tests revealed marked anemia. Contrast-enhanced CT and MRI demonstrated a 30-mm tumor in the second portion of the duodenum with pancreatic invasion. Upper gastrointestinal endoscopy revealed a type II ulcerative tumor with peripheral bleeding, and biopsy confirmed clear cell carcinoma. Given the anemia caused by tumor bleeding, pancreaticoduodenectomy was performed with curative intent. Histopathological findings were consistent with metastatic OCCC. The patient has remained recurrence-free for 30 months postoperatively. CONCLUSIONS: We present a rare case of platinum-resistant OCCC with duodenal metastasis that was successfully managed with pancreaticoduodenectomy, resulting in long-term survival. Although the role of surgical resection in such cases remains uncertain, this case suggests that curative surgery may be beneficial in selected patients.