Metastases to ovary

Metastases to ovary

Topic Completed: 1 February 2016

Minor changes: 4 March 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Metastases [title] ovary

Nalini Gupta, M.D.
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Cite this page: Gupta N. Metastases to ovary. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumormetastatic.html. Accessed October 21st, 2021.
Definition / general
  • Common site for metastases; 5-10% of ovarian tumors are metastases (Acta Medica Medianae 2007;46:61)
  • Usually are bilateral, small, multinodular surface tumors with extensive extraovarian spread
  • Most common metastases are from endometrium, appendix (adenocarcinoid or mucinous adenocarcinoma), breast, colon, carcinoid, pancreas and stomach
  • Metastatic mucinous carcinomas are most difficult to distinguish from primary mucinous ovarian neoplasm
Clinical features
  • Symptoms of primary tumor with or without abdominal mass / pain / rectal bleeding / jaundice
  • Final diagnosis by histology and immunohistochemistry
  • CA125 normal or raised
Case reports
  • Debulking surgery with or without chemotherapy
Clinical images

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Solid cystic bilateral ovarian mass

Gross description
  • Laterality: mostly bilateral
  • Size: mostly < 10cm
  • Surface involvement: mostly multiple small nodules on surface
  • Extensive intraabdominal spread: mostly true for metastatic mucinous tumor
  • Hilar involvement common in hematogenous spread
Microscopic (histologic) description
  • Similar to primary tumor
  • Multinodular growth pattern with intervening normal ovarian parenchyma
  • Multiple vascular emboli
  • Specific pattern favouring metastasis includes signet ring cell carcinoma, pseudomyxoma peritoni, colloid carcinoma, infiltrative pattern of small glands with desmoplastic reaction, single cell infiltration
Microscopic (histologic) images

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Signet ring cells

Positive stains
  • Depends on primary tumor:
Negative stains
Differential diagnosis
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