Ovarian Metastasis from Pancreatic Ductal Adenocarcinoma

Abstract

Background Pancreatic ductal adenocarcinoma (PDAC) has a high propensity for systemic dissemination. Ovarian metastases are rare and poorly described. Methods We identified PDAC cases with ovarian metastasis from a prospectively maintained registry. We reported on the association between outcomes and clinicopathologic factors. Recurrence‐free (RFS) and overall survival (OS) were calculated using Kaplan–Meier analysis. Results Twelve patients with PDAC and synchronous or metachronous ovarian metastases were identified. Nine patients (75%) underwent pancreatectomy for localized PDAC and developed metachronous ovarian recurrence. The median OS for all patients was 25.4 (IQR:15.4–82.9) months. For the nine patients with metachronous ovarian metastasis, the median RFS and OS were 14.2 (IQR:7.2–58.3) and 44.6 (IQR:18.6–82.9) months, respectively. Nodal disease, poor grade, vascular invasion in the pancreatic primary, and bilateral ovarian disease tended to confer worse outcomes. Conclusion Patients with resected PDAC and ovarian recurrence tend to have a comparable disease course to more common patterns of recurrence. Primaries with nodal disease, poorer grade, vascular invasion, and bilateral ovarian disease were indicative of more aggressive disease biology. The ideal management remains largely unknown, and future collaborative efforts should optimize therapeutic strategies.

Metastatic ovarian tumor from pancreatic cancer treated with combined immunotherapy: A case report

“…In addition, patients with PC have the lowest survival rates among all cancer types, with only ~4% surviving beyond 5 years ( 4 ). The histology of PC is characterized by its aggressiveness, leading to early infiltration and a high propensity for systemic dissemination ( 5 ). The most common site of PC metastasis is the liver (40–50%) ( 6 ), with other commonly affected organs include the lungs, bones, adrenal glands, stomach lying adjacent to the pancreas, duodenum, transverse colon and left kidney ( 7 ).…”

“…The most common site of PC metastasis is the liver (40–50%) ( 6 ), with other commonly affected organs include the lungs, bones, adrenal glands, stomach lying adjacent to the pancreas, duodenum, transverse colon and left kidney ( 7 ). Compared with the aforementioned target organs, the ovary is an uncommon site for PC metastasis ( 5 ). Secondary ovarian malignancies account for 10–25% of all ovarian tumors ( 8 ), where the mechanism of dissemination may be through implantation, lymphatic and/or hematological metastasis ( 5 ).…”

“…Compared with the aforementioned target organs, the ovary is an uncommon site for PC metastasis ( 5 ). Secondary ovarian malignancies account for 10–25% of all ovarian tumors ( 8 ), where the mechanism of dissemination may be through implantation, lymphatic and/or hematological metastasis ( 5 ).…”