Difference between revisions of "Ovarian metastasis"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Adenocarcinoma_of_the_breast_metastatic_to_the_ovary_-_low_mag.jpg | |||
| Width = | |||
| Caption = Ovary with a metastasis from breast carcinoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = ovarian primary tumours - esp. [[ovarian mucinous carcinoma]], [[serous carcinoma of the ovary]], [[endometrioid carcinoma of the ovary]] | |||
| Stains = | |||
| IHC = dependent on primary site | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = classically bilateral masses <10 cm | |||
| Grossing = | |||
| Staging = | |||
| Site = [[ovary]] - see ''[[ovarian tumours]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = +/-malignancy elsewhere | |||
| Signs = +/-abdominal mass | |||
| Symptoms = +/-pain, +/-abdominal distension | |||
| Prevalence = | |||
| Bloodwork = serology suggestive of other primary, e.g. elevated [[CEA]] | |||
| Rads = adnexal mass/ovarian mass | |||
| Endoscopy = | |||
| Prognosis = poor | |||
| Other = | |||
| ClinDDx = ovarian primary | |||
| Tx = | |||
}} | |||
An '''ovarian metastasis''' (also '''ovary with metastatic disease''' and '''metastatic ovarian disease''') is [[cancer]] in the [[ovary]] that arose elsewhere and spread to the ovary. | An '''ovarian metastasis''' (also '''ovary with metastatic disease''' and '''metastatic ovarian disease''') is [[cancer]] in the [[ovary]] that arose elsewhere and spread to the ovary. | ||
Revision as of 05:32, 28 January 2016
Ovarian metastasis | |
---|---|
Diagnosis in short | |
Ovary with a metastasis from breast carcinoma. H&E stain. | |
LM DDx | ovarian primary tumours - esp. ovarian mucinous carcinoma, serous carcinoma of the ovary, endometrioid carcinoma of the ovary |
IHC | dependent on primary site |
Gross | classically bilateral masses <10 cm |
Site | ovary - see ovarian tumours |
| |
Clinical history | +/-malignancy elsewhere |
Signs | +/-abdominal mass |
Symptoms | +/-pain, +/-abdominal distension |
Blood work | serology suggestive of other primary, e.g. elevated CEA |
Radiology | adnexal mass/ovarian mass |
Prognosis | poor |
Clin. DDx | ovarian primary |
An ovarian metastasis (also ovary with metastatic disease and metastatic ovarian disease) is cancer in the ovary that arose elsewhere and spread to the ovary.
Generally
- Mostly Muellerian origin (uterus, fallopian tube) or pelvic peritoneum.
Common extramuellerian metastatic tumours:
- Breast.
- Gastrointestinal (GI) tract.
- Pseudomyxoma peritonei, usu. appendiceal origin.
- Krukenberg tumour = signet ring cell cancer with mucin production of GI origin.
Gross
Features favouring metastatic mucinous carcinoma (from the GI tract) over primary ovarian mucinous carcinoma:[1]
- Bilaterality - both ovaries involved.
- Small unilateral tumour size.
- <10 cm suggests metastasis.
- >13 cm = ovarian primary.
Microscopic
Features:
- Predominantly surface involvement and nodular at low power.
- +/-Signet ring cells (suggestive of GI or breast primary).
- Lymphovascular invasion.
Image
IHC
Ovarian tumours:
- Dipeptidase 1 (DPEP1) +ve.[2]
- CK7 +ve.
See also
References
- ↑ Yemelyanova, AV.; Vang, R.; Judson, K.; Wu, LS.; Ronnett, BM. (Jan 2008). "Distinction of primary and metastatic mucinous tumors involving the ovary: analysis of size and laterality data by primary site with reevaluation of an algorithm for tumor classification.". Am J Surg Pathol 32 (1): 128-38. doi:10.1097/PAS.0b013e3180690d2d. PMID 18162780.
- ↑ Okamoto, T.; Matsumura, N.; Mandai, M.; Oura, T.; Yamanishi, Y.; Horiuchi, A.; Hamanishi, J.; Baba, T. et al. (Feb 2011). "Distinguishing primary from secondary mucinous ovarian tumors: an algorithm using the novel marker DPEP1.". Mod Pathol 24 (2): 267-76. doi:10.1038/modpathol.2010.204. PMID 21076463.