Clinicopathological Features of Metastatic Colorectal Carcinoma in Multiple Primary Malignancies: A Case Report
DOI:
https://doi.org/10.56951/3w990192Kata Kunci:
karsinoma kolorektal, metastasis kolorektal ke ovarium, CK20, SATB2, CDX2, kanker payudara metachronous, keganasan primer multipelAbstrak
Latar belakang: Keganasan primer multipel pada pasien merupakan kondisi yang jarang terjadi dan menimbulkan tantangan yang signifikan dalam penegakan diagnosis, terutama ketika timbul lesi metastasis yang menyulitkan identifikasi asal tumor primernya. Kasus: Seorang wanita pascamenopause berusia 60 tahun dengan riwayat karsinoma payudara yang tidak diterapi datang dengan keluhan nyeri perut akut, distensi progresif, dan konstipasi. Pemeriksaan pencitraan menunjukkan adanya massa multipel di pelvis dengan keterlibatan omentum. Pasien kemudian menjalani laparotomi eksploratif, meliputi histerektomi abdominal total, pengangkatan massa adneksa bilateral, dan omentektomi. Temuan intraoperatif menunjukkan adanya tumor ovarium bilateral, invasi miometrium, dan nodul omentum. Pemeriksaan histopatologi menunjukkan gambaran adenokarsinoma terdiferensiasi baik hingga sedang. Analisis imunohistokimia menunjukkan bahwa lesi pada ovarium, miometrium, dan omentum merupakan metastasis adenokarsinoma kolorektal, dengan ekspresi positif terhadap CK20, CDX2, dan SATB2. Sementara itu, biopsi dari payudara mengonfirmasi adanya karsinoma invasif metachronous tipe luminal–B like, yang tidak berkaitan dengan lesi pelvis tersebut. Kesimpulan: Kasus ini menunjukkan kompleksnya
diagnosis massa pelvis pada pasien dengan keganasan multipel. Metastasis ovarium dari karsinoma kolorektal dapat
menyerupai tumor ovarium primer, terutama pada wanita pascamenopause. Temuan massa ovarium bilateral dengan
adenokarsinoma infiltratif meningkatkan kecurigaan terhadap metastasis, yang didukung oleh profil CK20+/CK7-/SATB2+
/CDX2+. Evaluasi histopatologi dan imunohistokimia yang komprehensif sangat penting untuk menegakkan diagnosis yang akurat serta penatalaksanaan yang tepat.
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Hak Cipta (c) 2026 Patricia Diana Prasetiyo, Jennifer Jesse Limanto, Alexy Oktoman Djohansjah, Alif Rizky Soeratman
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