D. Perucchini et al., METASTASING OF EXTRAGENITAL TUMORS TO THE OVARIES AT THE DEPARTMENT OF GYNECOLOGY OF THE UNIVERSITY-OF-ZURICH 1978-1990, Geburtshilfe und Frauenheilkunde, 56(7), 1996, pp. 351-356
37 cases of extragenital tumours metastatic to the ovaries are analyse
d from a clinicopathological viewpoint. In 25 out of 334 patients who
were operated on between 1978 and 1990 because of a palpable malignant
ovarian tumour, ovarian involvement from extragenital cancer was diag
nosed, The most frequent primary sites were the stomach (n = 7), colon
(n = 6) and breast (n = 6). 4 of the 6 patients with metastatic colon
carcinoma had previously documented diagnosis of colon cancer with a
time interval between diagnosis of primary tumours and secondary ovari
an tumour ranging up to 11 years. Only one patient had a previously kn
own stomach cancer, operated on 32 months earlier. All our patients wi
th gastrointestinal primary tumour died within 1 year (gastric origin)
of detection of metastases and 2 years (colon carcinoma) except for o
ne patient with metastasis of colon carcinoma, who is still living aft
er more than 4 years and one patient with gastric carcinoma who surviv
ed 34 months after oophorectomy. Surprisingly, ovarian metastases of b
reast cancer were detected before the primary tumour in 2 out of 6 cas
es. The other 4 patients were operated on because of an ovarian tumour
but had a known and previously operated breast cancer, 27 patients ha
d therapeutic ovarian ablation in metastatic breast cancer without a p
alpable pelvic mass. None of these patients had symptoms related to th
e ovaries. In 12 (40%) patients we found microscopic metastases which
were bilateral in 9 cases. Metastases to the ovary may not infrequentl
y mimic primary ovarian tumour and are difficult to diagnose preoperat
ively, We hope that some clinical features described by us (nationalit
y, patient's history, bilateral ovarian tumours in young women) will a
lert the clinician to investigate further in order to achieve the best
possible therapeutic management, because some patients may benefit fr
om adequate treatment and survive for a long time.