Laparotomy for „ovarian tumors” in unsuspected carcinoma of the colon

One hundred forty-eight cases of carcinoma of the colon in women from the University of Oregon Medical School Hospitals and Clinics are reviewed and seven cases presented in which the primary lesion was unsuspected prior to a laparotomy for „ovarian mass.”︁ The incidence of ovarian metastases is discussed. The following conclusions are drawn: Taking a very careful gastrointestinal history and maintaining a high index of suspicion is prerequisite to detecting carcinomas of the colon in women with pelvic masses. Patients with suspected ovarian masses should undergo sigmoidoscopy and a barium enema as a minimum for preoperative evaluation. Bowel preparation is indicated if the evaluation is even suggestive of colonic carcinoma. A meticulous exploration is essential at the time of laparotomy before resection for cure of any colonic or ovarian carcinoma. Bilateral oophorectomy may be justified for palliation at the time of resection for carcinoma of the colon.