We report a rare case of primary jejunal adenocarcinoma with metastasis to ovary in a 23 year old female. She presented with four days’ history of abdominal pain and vomiting. Barium meal follows through findings were suggestive of stricture for which resection was done. Pathological evaluation of resected specimen showed well differentiated adenocarcinoma grade-1, extending through the wall and adjoining mesentery. She was treated with adjuvant combination chemotherapy. Four months after completion of 6th chemotherapy cycle, she came with complaint of pain in abdomen. Physical examination and imaging studies revealed solid cystic lesion in right adenexal region. Excision of right tubo-ovarian mass, right salpingo-oopherectomy, and excision of previous jejuno-jejunal anastomosis with reanastomosis was done.
Histopathology and immunohistological staining of resected specimen revealed that tumor cells were positive for CK20 and CEA and negative for CK7 and CA125, favouring a diagnosis of metastatic carcinoma. The patient was again treated with oxaliplatin, 5-fluorouracil, and leucovorin based chemotherapy and recovered uneventfully. The case is reported in view of its clinical significance and rarity.