METASTASIS OF BREAST-CARCINOMA TO A PRIMARY MUCINOUS CYSTADENOCARCINOMA OF THE OVARY

A case of a patient with breast cancer metastatic within the tumor str oma of a primary ovarian carcinoma is presented. This finding is to th e best of our knowledge the first case reported. The encountered diagn ostic problems are discussed. A distinct peroperative frozen section d iagnosis on the large, cystic, partially necrotic ovarian mass was not possible because of sampling problems. A comparable immunohistochemic al staining pattern of cells being CEA negative, OC-125 negative, and HMFG-1 positive was found in both the primary breast tumor and in the solid epithelial parts in the tumor stroma of the left-sided ovarian c arcinoma, as well as in the stroma of the right ovary. Immunohistochem ical findings in the left-sided epithelial cystic ovarian tumor showed , as expected, apical reactivity with antibodies directed against CEA, whereas OC-125 and HMFG-1 were negative. Ploidy analysis showed that the primary breast carcinoma and the stromal part of left ovarian mali gnancy had the same aneuploid stemlines (DNA index = 1.18). The epithe lial lining of the cystic ovarium carcinoma not showing the presence o f a metastatic lesion in its stroma showed the presence of a diploid G O,1 population only. These results show that DNA flow cytometry and im munohistochemistry may be helpful in assessing the origin of the malig nancies in this unusual double presentation of both metastatic breast cancer and primary ovarian carcinoma. (C) 1994 Academic Press, Inc.