A case of ovarian carcinosarcoma with germline BRCA2 pathogenic variant

J Obstet Gynaecol Res. 2024 Dec;50(12):2362-2366. doi: 10.1111/jog.16134. Epub 2024 Oct 29.

Abstract

Ovarian carcinosarcoma in hereditary breast and ovarian cancer syndrome is rare. A 43-year-old woman with a family history of prostate and uterine or ovarian cancer had an 8-cm mass in the right ovary. Although computed tomography suggested peritoneal dissemination to the Douglas pouch, she wanted to preserve her fertility; therefore, she underwent a right salpingo-oophorectomy. Histopathological diagnosis was carcinosarcoma consisting of high-grade serous carcinoma and sarcomatous components, including cartilage. Three weeks later, she underwent radical surgery. The disease was classified as advanced stage IIIB (FIGO 2014). A germline BRCA2 pathogenic variant was identified. After postoperative adjuvant chemotherapy, maintenance therapy with a poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor was continued for 25 months without recurrence. A detailed examination of a mass in her left breast at her first visit revealed a ductal carcinoma in situ. PARP inhibitors may be effective as maintenance therapy for advanced ovarian carcinosarcoma with germline BRCA mutations.

Keywords: BRCA; germline pathogenic variant; hereditary breast and ovarian cancer syndrome (HBOC); ovarian carcinosarcoma; poly(adenosine diphosphate‐ribose) polymerase (PARP) inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • BRCA2 Protein* / genetics
  • Carcinosarcoma* / diagnosis
  • Carcinosarcoma* / genetics
  • Carcinosarcoma* / pathology
  • Female
  • Germ-Line Mutation*
  • Humans
  • Ovarian Neoplasms* / diagnosis
  • Ovarian Neoplasms* / genetics
  • Ovarian Neoplasms* / pathology
  • Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use

Substances

  • BRCA2 Protein
  • BRCA2 protein, human
  • Poly(ADP-ribose) Polymerase Inhibitors