Ovary tumor
Metastases to ovary
General

Authors: Nalini Gupta, M.D. (see Authors page)

Revised: 17 June 2016, last major update February 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Metastases [title] ovary
Cite this page: Metastases to ovary. PathologyOutlines.com website. http://pathologyoutlines.com/topic/ovarytumormetastatic.html. Accessed November 23rd, 2017.
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
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
Treatment
  • 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
Gross images

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Bilateral ovarian masses with surface nodularity

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 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