Ovary
Metastases to ovary
Metastases to ovary
Author: Nalini Gupta, M.D.
Last author update: 1 February 2016
Last staff update: 1 May 2023 (update in progress)
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Metastases [title] ovary
Table of Contents
Definition / general | Pathophysiology | Clinical features | Diagnosis | Laboratory | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Gupta N. Metastases to ovary. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumormetastatic.html. Accessed June 9th, 2023.
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
Pathophysiology
- Tumors can spread to the ovary by several pathways:
- Direct spread
- Transcoelomic dissemination
- Hematogeneous spread
- Lymphatic spread (Obstet Gynecol Int 2011;2011:612817)
Clinical features
- Symptoms of primary tumor with or without abdominal mass / pain / rectal bleeding / jaundice
Diagnosis
- Final diagnosis by histology and immunohistochemistry
Laboratory
- CA125 normal or raised
Case reports
- 46 year old woman with bilateral metastatic ovarian tumors in the course of stomach cancer (Arch Gynecol Obstet 2002;267:95)
- Ovarian metastases in colorectal cancer (Int J Gynecol Cancer 2009;19:1524)
Treatment
- Debulking surgery with or without chemotherapy
Clinical images
Images hosted on other servers:
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
Images hosted on other servers:
Signet ring cells
Positive stains
Differential diagnosis
- Primary mucinous tumor of ovary: CA125, CK7 positive
