A case of bowel perforation after neoadjuvant chemotherapy for advanced epithelial ovarian cancer

Background.Bowel perforation is a rare complication of chemotherapeutic treatment of cancer, and may result from tumor necrosis within involved bowel or as a function of the mechanism of the chemotherapeutic agent itself.Case.We present a case of a 71-year-old woman who experienced a spontaneous bowel perforation after a single cycle of carboplatin and paclitaxel during neoadjuvant treatment of advanced epithelial ovarian cancer. This is, to our knowledge, the first reported case of a gastrointestinal perforation with neoadjuvant chemotherapy for ovarian cancer. The clinical circumstances were highly suggestive of a tumor lysis mechanism for the perforation.Conclusion.Bowel perforation can occur as a direct consequence of cytotoxic neoadjuvant chemotherapy for advanced ovarian cancer. This potential serious complication may be worthy of consideration when deciding between neoadjuvant chemotherapy and primary surgical management.