Parkinson Hastalığı Olan Bir Hastada Senkron TP53-Aberrant Ovarian ve Servikal Karsinomlar: Moleküler Öngörüler ve Klinik Zorluklar

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Abstract Background The synchronous occurrence of bilateral ovarian high-grade serous carcinoma (HGSC) and primary gastric-type endocervical adenocarcinoma (GEA) is exceedingly rare, with limited understanding of their molecular relationship and clinical management. This report presents a unique case of dual primary gynecologic malignancies in a patient with Parkinson’s disease, highlighting diagnostic challenges, therapeutic complexities, and potential shared oncogenic pathways. Case Presentation: A 67-year-old female with a 6-year history of Parkinson’s disease presented with lower abdominal distension, pain, and altered bowel habits. Imaging revealed bilateral adnexal masses with local invasion. Surgical resection confirmed synchronous bilateral HGSC (FIGO stage III) and GEA (superficial myometrial invasion), both exhibiting aberrant p53 expression (heterogeneous pattern), high Ki-67 (∼80%), and mismatch repair proficiency. Immunohistochemical profiling suggested involvement of the BRCA/TP53 pathway. Conclusion This case underscores the rarity of synchronous HGSC and GEA, both demonstrating TP53 dysfunction, potentially indicating a common molecular etiology. Comprehensive genetic testing (e.g., BRCA1/2, TP53) is critical to elucidate clonality and guide targeted therapy. The presence of Parkinson’s disease further complicates management, emphasizing the need for personalized, multimodal treatment strategies. This report advocates for heightened clinical suspicion of synchronous malignancies in patients with persistent pelvic symptoms and supports integrated molecular profiling to optimize therapeutic outcomes.

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