Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites

Abstract

Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.

Jejunal cancer detected after a resection of bilateral ovarian metastasis: Report of a case

“…6 Turan et al reported that the primary tumor sites were not detected even after an oophorectomy in 12.1% of metastatic ovarian tumors. 2 Turan et al also reported gastric cancer to be the most common primary tumor metastasizing to the ovary (37.3%) followed by colorectal cancer (28%), lymphoma (12%), and breast cancer (6.7%). 2 The incidence of the small intestine as the primary tumor site of metastatic ovarian tumor ranges from 1.3% to 6.8%.…”

“…2 Turan et al also reported gastric cancer to be the most common primary tumor metastasizing to the ovary (37.3%) followed by colorectal cancer (28%), lymphoma (12%), and breast cancer (6.7%). 2 The incidence of the small intestine as the primary tumor site of metastatic ovarian tumor ranges from 1.3% to 6.8%. 1,2,5 The small intestine is not the usual primary site of the ovarian metastasis.…”

“…4 Ovarian metastasis from jejunal cancer is rare. 1,2,5 This report describes a case of ovarian metastasis from primary jejunal cancer, which was detected after the resection of the ovarian metastasis.…”

“…1,2 Metastatic ovarian tumors sometimes demonstrate symptoms before the primary sites can be detected. 3 The most common extragenital primary sites of metastatic ovarian tumor are the colon, stomach, and breast.…”

“…3 The most common extragenital primary sites of metastatic ovarian tumor are the colon, stomach, and breast. 1,2 Primary adenocarcinoma of the jejunum is not commonly encountered in clinical practice, and its incidence accounts for approximately 3% of all gastrointestinal tract malignancies. 4 Ovarian metastasis from jejunal cancer is rare.…”