Background: Rectal tumors are rarely metastatic. Moreover, hematogenous spread is rare in ovarian cancer whose dissemination frequently occurs through peritoneal or lymphatic ways.
Case: A 55-year-old female presented with a rectal metastasis that appeared 20 years after the treatment of a primary clear cell carcinoma of the ovary. The cytokeratin 7 positive/cytokeratin 20 negative immunophenotype assessed the ovarian origin of the rectal tumor. Because of the integrity of the rectal serosa and the uninvolved mesenteric lymph nodes, we hypothesize our rectal metastasis to come from the hematogenous way.
Conclusion: This is the first reported case of hematogenous rectal metastasis in epithelial ovarian carcinoma and that, with so late delay.