Obstetrics & Gynecology

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Obstetrics & Gynecology:
doi: 10.1097/AOG.0b013e3181b6f4f9
Case Reports

Primary Peritoneal Cancer After Bilateral Salpingo-Oophorectomy in Two Patients With Lynch Syndrome

Schmeler, Kathleen M. MD1; Daniels, Molly S. MS2; Soliman, Pamela T. MD, MPH1; Broaddus, Russell R. MD, PhD3; Deavers, Michael T. MD3; Vu, Thuy M. MS2; Chang, George J. MD, MS4; Lu, Karen H. MD1

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Abstract

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.

© 2010 The American College of Obstetricians and Gynecologists

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