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Case Reports
. 2024 Jun 3;28(2):348.
doi: 10.3892/ol.2024.14481. eCollection 2024 Aug.

Skin metastasis from ovarian cancer with somatic BRCA1 mutation: A case report and literature review

Jingheng Zhang  1   2 , Wenfeng He  1 , Zhenhua Zhang  1 , Hui Dong  3 , Xiangyu Deng  1 , Qinglian Wen  1   4 , Dan Li  1
Affiliations
Case Reports

Skin metastasis from ovarian cancer with somatic BRCA1 mutation: A case report and literature review

Jingheng Zhang et al. Oncol Lett. .

Abstract

Skin metastasis from ovarian cancer is rare, and its prognosis is poor. Effective therapeutic strategies are currently lacking, but the combination of various treatment methods shrink the tumor and relieve symptoms. The present study reports a rare case of advanced ovarian cancer with skin metastases and intestinal wall thickening, along with a BRCA1 DNA repair associated (BRCA1) mutation. After standard first-line treatment and non-standard second-line treatment, the patient developed skin metastases. The patient's skin itching, pain and lesions were completely relieved after administering bevacizumab in combination with paclitaxel and carboplatin. After 4 months, skin metastases recurred along with anal distension during maintenance treatment with oral poly(ADP ribose) polymerase (PARP) inhibitors. The patient was treated again with bevacizumab combined with docetaxel, and the anal distension was significantly relieved. Angiogenesis therapy combined with chemotherapy is effective, but that the disease-free survival time is short, and PARP inhibitor maintenance effect is limited even in cases with a BRCA1 gene mutation.

Keywords: BRCA1 DNA repair associated; angiogenesis; bevacizumab; intestinal wall thickening; ovarian neoplasms; poly(ADP ribose) polymerase inhibitors.

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Conflict of interest statement

The authors declare that there are no competing interests.

Figures

Figure 1.
Figure 1.
Pathological images of the patients at initial diagnosis. (A) shows high-grade serous adenocarcinoma invading the fibrous connective tissue of the dermis, (B) shows atypical glands of high-grade serous adenocarcinoma(haematoxylin and eosin staining; ×200 magnification). Immunohistochemistry (×200 magnification): (C) Cancer antigen 125 and (D) tumor protein p53 staining.
Figure 2.
Figure 2.
Timeline of treatments and disease status. PR, partial response; PD, progressive disease; SD, stable disease; PARP, poly(ADP ribose) polymerase.
Figure 3.
Figure 3.
CT images of the patient's recurrence. (A) Shows the patient's right axillary lymph node enlargement, and (B) the left axillary lymph node enlargement. (C) Shows a poorly defined boundary on the posterior bladder wall of the vaginal stump and slightly swollen rectal wall, and (D) shows an enhanced nodule on the posterior wall of the vaginal stump.
Figure 4.
Figure 4.
Pathological images of the patient at the time of skin metastasis. (A and B) Typical histopathological image of two different locations (haematoxylin and eosin staining; ×200 magnification). (C) Paired box protein Pax-8 and tumor protein p53 staining. (D) Immunohistochemistry (×200 magnification).
Figure 5.
Figure 5.
Skin appearance of the patient. (A) Appearance of back and (B) Appearance of lower limb skin before treatment. (C) Appearance of back skin after treatment. (D) Appearance of lower limb skin after treatment.
Figure 6.
Figure 6.
T1-weighted magnetic resonance images. (A) Rectum wall thickening before treatment. (B) Thickness of the rectum wall improved after two cycles of treatment.
See this image and copyright information in PMC

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