Secondary Ovarian Malignancy in an Imatinib treated Chronic Myeloid Leukemia Patient Diagnosed on Fluid Cytology

Abstract

A BCR-ABL fusion product identifies chronic myeloid leukemia as a clonal myeloproliferative tumor. Tyrosine kinase inhibitors have become more widely used to treat chronic myeloid leukemia, although there is still little known about their long-term negative effects, such as the possibility of additional cancers. The most common secondary malignancies reported in CML are localized to the gastrointestinal tract, prostate, lung, non-Hodgkins lymphoma, malignant melanoma and breast cancer. Herein, we report a case of serous papillary adenocarcinoma of the ovary in a known case of chronic myeloid leukemia on imatinib therapy for the past three years. The 46-year-old lady presented to us with massive ascites. Cytological examination revealed features of a papillary adenocarcinoma. The cytological diagnosis was further confirmed by immunohistochemistry on the cell block. Secondary ovarian adenocarcinoma following imatinib therapy for chronic myeloid leukemia is uncommon with only one case reported to date. It is important to evaluate the long-term effects of imatinib therapy especially the risk of developing secondary malignancies.