Primary Peritoneal Cancer After Bilateral Salpingo-Oophorectomy in Two Patients With Lynch Syndrome.
Schmeler, Kathleen M. MD 1; Daniels, Molly S. MS 2; Soliman, Pamela T. MD, MPH 1; Broaddus, Russell R. MD, PhD 3; Deavers, Michael T. MD 3; Vu, Thuy M. MS 2; Chang, George J. MD, MS 4; Lu, Karen H. MD 1
Obstetrics & Gynecology.
115(2, Part 2) Supplement:432-434, February 2010.
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BACKGROUND: Women with Lynch syndrome or hereditary nonpolyposis colorectal carcinoma (HNPCC) have a 40-60% lifetime risk of endometrial cancer and a 7-12% lifetime risk of ovarian cancer. Risk-reducing surgery, including hysterectomy and bilateral salpingo-oophorectomy (BSO), is currently recommended once child bearing is complete. We describe two cases of primary peritoneal cancer after BSO in women with Lynch syndrome or HNPCC.
CASES: The first patient was a 44-year-old woman who underwent hysterectomy with BSO for benign disease. She presented 12 years later with a pelvic mass and was diagnosed with a high-grade serous primary peritoneal cancer. Genetic testing showed a mutation in the MSH2 DNA mismatch repair gene. The second case was a 58-year-old woman who had a hysterectomy and BSO for endometrial cancer. She developed a high-grade serous primary peritoneal cancer 8 years later and was found to have a mutation in the PMS2 DNA mismatch repair gene.
CONCLUSION: Women with Lynch syndrome or HNPCC should be counseled that they may be at risk for developing primary peritoneal cancer despite undergoing gynecologic cancer risk-reducing surgery. The magnitude of this risk remains to be determined.
(C) 2010 The American College of Obstetricians and Gynecologists