Despite primary colorectal cancer being the third frequent malignancy worldwide, secondary metastasis to the large bowel from another primary cancer is seldom reported. Only a handful of previous cases of primary ovarian cancer metastasizing to the large bowel have been described in literature published in English up to date. We report a case of bilateral ovarian carcinoma with synchronous dual metastasis to the left colon, probably the first report of such nature. A 56-year-old Sri Lankan female presented with left-sided non-specific abdominal pain for 2 months. She was found to have bilateral ovarian tumours with elevated serum CA 125 levels, and near-occluding splenic flexure and descending colon masses. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, left hemicolectomy with regional lymph node dissection and omentectomy. Histology confirmed endometrioid adenocarcinoma of both ovaries with metastatic deposits in both colonic masses and in two out of seven lymph nodes along the left colic vascular pedicle. Both ovarian tumours and both colonic deposits were positively stained for ER and vimentin, and were negative for CK20 on immunohistochemistry indicating ovarian origin. The patient was disease-free at 2 years from the uncomplicated primary surgery having completed adjuvant chemotherapy. This case highlights the importance of the clinicians to be mindful of rare occurrences of large bowel secondary deposits of ovarian origin, especially when patients present with simultaneous large bowel and adnexal masses. Upfront bowel resection than neoadjuvant therapy could be performed safely in cases with impending bowel obstruction with satisfactory outcome.

尽管原发性结直肠癌是全球第三大常见恶性肿瘤，但另一种原发性癌症继发性转移至大肠的报道却很少。迄今为止以英文发表的文献中仅描述了少数原发性卵巢癌转移至大肠的病例。我们报告了一例双侧卵巢癌同时双侧转移至左结肠的病例，这可能是此类性质的第一个报告。一名 56 岁斯里兰卡女性出现左侧非特异性腹痛 2 个月。她被发现患有双侧卵巢肿瘤，血清 CA 125 水平升高，脾曲近闭塞和降结肠肿块。患者接受了全腹部子宫切除术、双侧输卵管卵巢切除术、左半结肠切除术、区域淋巴结清扫术和大网膜切除术。组织学证实双侧卵巢子宫内膜样腺癌，两个结肠肿块和沿左结肠血管蒂的七个淋巴结中有两个有转移性沉积。免疫组织化学显示，卵巢肿瘤和结肠沉积物的 ER 和波形蛋白染色呈阳性，而 CK20 染色呈阴性，表明卵巢来源。患者在完成辅助化疗后，在简单的初次手术后 2 年时已无疾病。该病例强调了临床医生注意罕见的卵巢来源的大肠继发性沉积物的重要性，特别是当患者同时出现大肠和附件肿块时。在即将发生肠梗阻的病例中，与新辅助治疗相比，提前进行肠切除术可以安全地进行，并获得满意的结果。