LETTER

Hippokratia 2012, 16, 4: 391

Gavriilidis P¹, Ananiadis A¹, Theodoulidis V¹, Toskas I¹, Barbanis S²
1Department of Surgical Oncology, 2Department of Pathology, Theageneio Anticancer Hospital, Thessaloniki, Greece

 

Read PDF

Keywords:  Ovarian metastasis, invasive ductal breast carcinoma, invasive lobular cancer, ovary tumour

Correspoding author: Dr Paschalis Gavriilidis, 2 A Simeonidi STR, 54641 Thessaloniki, Greece, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 
Dear Editor,

Ovarian metastases are detected in 10%-20% of autopsies and 30% of therapeutic oophorectomy specimens from cases of breast carcinoma. Approximately 6%-7% of ovarian cancers and 10% of bilateral ovarian malignancies discovered during surgical intervention are metastatic1,2. Although invasive lobular carcinoma has a much greater tendency to metastasize to the ovary, 75% of ovarian metastases are from invasive ductal cancers due to its higher prevalence1-4.

We present the case of 53 years old female, who was admitted with the diagnosis of a perforated viscus. She underwent laparotomy and was indentified with solid multinodular masses on both ovaries. A Hartmann’s procedure, omentectomy and total hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed perforation of the inflamed sigmoid diverticulum, ovarian masses histologically demonstrated metastatic cancer from invasive intraductal Ca grade III, keratin (+), e-cadherin (+), ER (+), PR (+), c-erb2 (-), cytokeratin(-), chromogranin(-). The serosal layer of the body of the uterus was invaded by the same carcinoma.

Ovarian metastases can occur long after treatment for primary breast cancer, with intervals ranging from 1-19 years, during the interventions can be mistaken easily for an ovarian primary2. Attention to clinical history and macroscopic features and awareness of this possibility, can help in minimizing errors.

References

1. Petru E, Pickel H, Heydarfadai M, Lahousen M, Haas J, Schaider H, et al. Nongenital cancers metastatic to ovary. Gynecol Oncol. 1992; 44: 83-86.
2. Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract. Analysis of 325 cases. Cancer 1984; 53: 1978-1984.
3. Ulbright TM, Roth LM, Stehman FB. Secondary ovarian neoplasia. A clinicopathologic study of 35 cases. Cancer 1984; 53: 1164-1174.
4. Liu LV. [Metastatic cancer in the ovary report of 57 cases]. Zhongua Zhong Liu Za Zhi. 1989; 11:464-467.