Pancreatic adenocarcinoma: Late recurrence in ovary

Hi all,

I’ve lurked on this board off and on for years but this is my first post. My mom (68, in excellent health) had a distal pancreatectomy/splenectomy in August 2020 for pancreas adenocarcinoma thought to have originated in a mucinous cyst. Had 12 rounds of FOLFIRINOX. Clear scans every 3 months/6 months up until last month when a new 7cm left ovarian cystic lesion showed up. She had surgery yesterday to remove the cyst along with both ovaries and tubes. Frozen section done during surgery suggests a recurrence of the pancreatic adenocarcinoma. Final pathology is pending, peritoneal washings were also done and pending. GYN Onc surgeon who did the BSO said no other disease was apparent in the pelvis.

She does have an ATM germline mutation which was also found in the original pancreas tumor. Ca19-9 most recently was 12, had been 3-6 since surgery (219 at original diagnosis).

This is really hard news to swallow. Has anyone been through a late recurrence in the ovary? Obviously we need to wait for the final pathology, but looks like recurrence is likely. Her oncology care has been through Cleveland Clinic (we have yet to meet with her oncologist as she’s still in hospital recovering from surgery yesterday), wondering if we need to look into a second opinion with Memorial Sloan Kettering or Penn Med - I know both have experience with germline mutations like ATM in pan cancer. Also interested in the possibility of HIPEC for her as it seems the most likely re-recurrence would be in the peritoneum?

Thanks for any input.