Ovarian metastasis: Difference between revisions
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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 (left of image). [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = predominantly surface involvement and nodular (especially at low power), +/-signet ring cells (suggestive of GI or breast primary), [[lymphovascular invasion]] | |||
| 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 = dependent on primary - often chemotherapy and radiation, occasionally de-bulking (surgery) | |||
}} | |||
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. | ||
==Generally== | ==Generally== | ||
* Mostly Muellerian origin (uterus, [[fallopian tube]]) or pelvic [[peritoneum]]. | * Mostly Muellerian origin ([[uterus]], [[fallopian tube]]) or pelvic [[peritoneum]]. | ||
Common extramuellerian metastatic tumours: | Common extramuellerian metastatic tumours: | ||
* [[Breast]]. | * [[Breast]]. | ||
* [[Gastrointestinal pathology|Gastrointestinal (GI) tract]]. | * [[Gastrointestinal pathology|Gastrointestinal (GI) tract]]. | ||
** Pseudomyxoma peritonei, usu. [[appendix|appendiceal]] origin. | ** [[Pseudomyxoma peritonei]], usu. [[appendix|appendiceal]] origin. | ||
** Krukenberg tumour = [[signet ring cell]] cancer with mucin production of GI origin. | ** Krukenberg tumour = [[signet ring cell]] cancer with mucin production of GI origin. | ||
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*Small unilateral tumour size. | *Small unilateral tumour size. | ||
**<10 cm suggests metastasis. | **<10 cm suggests metastasis. | ||
**>13 cm | **>13 cm suggests ovarian primary. | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Predominantly surface involvement and nodular at low power. | *Predominantly surface involvement and nodular at low power. | ||
*+/-[[Signet ring cell]]s (suggestive of GI or breast primary). | *+/-[[Signet ring cell]]s (suggestive of GI or breast primary). ‡ | ||
*[[Lymphovascular invasion]]. | *[[Lymphovascular invasion]]. | ||
=== | Note: | ||
*‡ ''Primary [[signet ring cell carcinoma]] of the ovary'' exists but is very rare.<ref name=pmid21611142>{{Cite journal | last1 = El-Safadi | first1 = S. | last2 = Stahl | first2 = U. | last3 = Tinneberg | first3 = HR. | last4 = Hackethal | first4 = A. | last5 = Muenstedt | first5 = K. | title = Primary signet ring cell mucinous ovarian carcinoma: a case report and literature review. | journal = Case Rep Oncol | volume = 3 | issue = 3 | pages = 451-7 | month = Sep | year = 2010 | doi = 10.1159/000323003 | PMID = 21611142 }}</ref> | |||
===Images=== | |||
====Breast carcinoma==== | |||
<gallery> | <gallery> | ||
Image:Adenocarcinoma_of_the_breast_metastatic_to_the_ovary_-_low_mag.jpg | Ovarian metastasis - low mag. (WC/ | Image:Adenocarcinoma_of_the_breast_metastatic_to_the_ovary_-_low_mag.jpg | Ovarian metastasis (breast) - low mag. (WC) | ||
</gallery> | |||
====Urothelial carcinoma==== | |||
<gallery> | |||
Image: Ovarian metastasis -- very low mag.jpg | Ovary metastasis (UCC) - very low mag. (WC) | |||
Image: Ovarian metastasis -- low mag.jpg | Ovary metastasis (UCC) - low mag. (WC) | |||
Image: Ovarian metastasis -- intermed mag.jpg | Ovary metastasis (UCC) - intermed. mag. (WC) | |||
Image: Ovarian metastasis - alt -- intermed mag.jpg | Ovary metastasis (UCC) - intermed. mag. (WC) | |||
</gallery> | </gallery> | ||