Bone metastasis in epithelial ovarian carcinoma

Dinh, Tung Van; Liebowitz, Beth; Hannigan, Edward V.; Schnadig, Vicki J.; Doherty, M.G.

doi:10.1016/0020-7292(95)02538-3

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…Distant metastases theoretically may occur anywhere (10) ; however, pleura (4,11) , liver (11) , lungs (12) , central nervous system (13,14) , spleen (15) , skin (11) , bone (16) , and breast (17) are in order the most commonly involved sites. In our study distant metastases were present in 8% of the patients at the time of diagnosis and in 22% of the patients during the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

Distant metastases in ovarian carcinoma

Cormio

Rossi

Cazzolla

et al. 2003

International Journal of Gynecological Cancer

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Distant metastases are unusual at presentation and during the course of ovarian carcinoma. The aim of the present study was to determine the incidence and prognostic factors of distant metastases consistent with stage IV disease in ovarian cancer patients. A retrospective chart review was conducted on 162 patients with epithelial ovarian carcinoma treated at our Unit between 1991 and 2000. Pertinent clinical information, pathologic data, treatment, and prognostic factors for survival following documentation of distant metastatic disease were collected. The significance of the association between metastatic status and various clinical variables was assessed using the standard chi-square test. Survival time was calculated from the time of diagnosis of ovarian cancer and from the time of diagnosis of the distant metastases. A logistic regression procedure was used to estimate the odds of metastatic status given the presence of certain clinical variables. A total of 67 metastatic sites were diagnosed in 50 patients. Thirteen patients (8%) had distant metastatic disease at the time of diagnosis, 37 patients (22%) had distant metastases at the time of recurrent of progressive disease. Site of metastases were: liver, 21; pleura, 11; lung, 8; central nervous system and skin, 7 each; extra-abdominal lymph nodes and spleen, 5 each; bone, 2; and breast, 1. Significant risk factors for the development of distant metastases were stage, grade, and lymph node involvement. Median interval time between diagnosis of ovarian cancer and documentation of metastatic disease was 44 months (range 3–105), and at the time of diagnosis of distant disease, 36 of 50 patients (72%) had other sites of disease (intra-abdominal or extra-abdominal). Median survival from diagnosis of distant disease was 12 months (range 1–58). In univariate analysis performance status (P = 0.03), the presence of other sites of disease (P = 0.04) and interval time between diagnosis of ovarian cancer and documentation of distant metases (P = 0.03) were the only factors significantly associated with survival. Long interval time remained significant for prognosis in multivariate analysis also (P = 0.04). Distant metastasis consistent with stage IV disease is a late complication that occurs in about one third of ovarian cancer patients. Prognosis after documentation of distant metastases is poor. We conclude the most important prognostic factor associated with survival is the interval time between diagnosis of ovarian cancer and documentation of distant metastases.

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Section: Discussionmentioning

confidence: 99%

Distant metastases in ovarian carcinoma

Cormio

Rossi

Cazzolla

et al. 2003

International Journal of Gynecological Cancer

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“…A third paper reported two patients with ovarian cancer who developed bony metastases (6). Advanced ovarian cancer typically presents when bulky pelvic disease produces gastrointestinal or genitourinary symptoms (1-3), which were not present in this case.…”

Section: Discussionmentioning

confidence: 76%

Bone metastasis as the presenting complaint in ovarian carcinoma

Kingston¹,

Sparkes²,

Leen³

et al. 2001

Acta Obstet Gynecol Scand

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Shoulder pain is a common presenting complaint in our orthopedic service. Most cases with the clinical features of rotator cuff tendinitis respond to intra-articular injection of corticosteroids and local anesthetic. In the case described below, a patient whose pain persisted despite injection was investigated further and found to have advanced ovarian cancer with a metastasis in the humeral head. This is a rare pattern of spread Fig. 1. Anteroposterior view of the right shoulder showing a lytic area in the humeral head.C Acta Obstet Gynecol Scand 80 (2001) and a previously unreported mode of presentation of ovarian cancer. Case reportA 52-year-old mother of three was referred to the orthopedic service with a four-month history of right shoulder pain. The pain was moderate, constant, exacerbated by movement, and kept her awake at night. There was no antecedent injury. She was otherwise well with no systemic complaints or weight loss, and was a non-smoker. On examination all shoulder movements were limited by pain. The provisional diagnosis was rotator cuff tendinitis. The shoulder was injected with lidocaine (Xylocaine) and methylprednisolone (Depo-Medrone) without symptomatic relief, and so she was admitted for further investigation.Plain X-ray of the right shoulder showed a lytic area in the humeral head (Fig. 1). MRI revealed a lesion in the head of the humerus (Fig. 2), and no rotator cuff pathology. 99 Tc bone scan showed increased uptake in both humeral heads. Chest X-ray revealed a mass lesion in the right midzone. CT of the thorax Fig. 2. Axial T1-weighted MRI image showing a destructive low-attenuation mass in the humeral head.Fig. 3. CT showing multiple low-attenuation liver lesions and a peritoneal nodule (arrowed).

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“…Osseous and soft tissue involvement is thought to occur either by direct extension from paraaortic or iliac lymph nodes, or by lymphatic or hematogenous spread [7,12]. Hematogenous or lymphatic spread may have occurred in our patient.…”

Section: Discussion and Treatmentmentioning

confidence: 90%

“…Metastases to bone are distinctly uncommon, with the prevalence reported as 1.6% [1-3, 6, 7, 15], with the most frequent subtype being papillary adenocarcinoma [7].…”

Section: Discussion and Treatmentmentioning

confidence: 99%

Chest Wall Mass in a 50-year-old Woman

Chatha

Rybak

Wittig

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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A 50-year-old postmenopausal woman presented with a 9-month history of a lump on her left anterior chest wall in the region of the 2nd and 3rd costochondral junction. She reported the mass changed in size and at times felt soft and fluctuant. It intermittently swelled, causing her local discomfort followed by periods of spontaneous regression, which would be accompanied by inflammation localized to the surrounding chest wall. Physical examination revealed a firm mass along the left superior chest wall measuring approximately 6 9 3 cm. It was fixed in position and slightly tender to palpation. She was afebrile. No other joint complaints were reported. She had a history of ovarian cancer diagnosed at age 24 years; the workup for metastatic disease to the bones and solid organs was negative at that time. Her ovarian cancer was treated with whole-abdomen radiation therapy, chemotherapy, and a total abdominal hysterectomy and bilateral salpingooophorectomy. She had no symptoms or signs of metastatic disease in the interim.Plain radiographs of the chest were noncontributory. CT and MRI of the chest wall were performed (Figs.

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Bone metastasis in epithelial ovarian carcinoma

Abstract: Two cases of bone metastasis in patients with epithelial ovarian carcinoma and a review of the literature are presented. Bone metastases detected antemortem are rare and herald a poor prognosis.

Cited by 14 publications

References 8 publications

Distant metastases in ovarian carcinoma

Distant metastases in ovarian carcinoma

Bone metastasis as the presenting complaint in ovarian carcinoma

Chest Wall Mass in a 50-year-old Woman

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