Jejunal adenocarcinoma presenting as a primary ovarian carcinoma

Objective. The aim of this case report was to evaluate the impact of immuno histochemical markers in diagnosing the primary site of adenocarcinoma in t he abdominopelvic region. Methods. Surgicopathologic data were obtained from laparotomy and necropsy. Paraffin-embedded tissue from the ovary and jejunum was stained with hemat oxylin and eosin, as well as with immunohistochemical stains for cytokerati n 20 and cytokeratin 7. Results. A 53-year-old African American woman underwent an emergency laparo tomy due to small bowel obstruction. During the operation, in addition to a complex adnexal mass as the cause of obstruction, a small solid jejunal tu mor was also identified. Pathologic evaluation of the two sites demonstrate d an infiltrating moderately to poorly differentiated adenocarcinoma with m ucinous features. The malignant cells from both intestinal and ovarian site s showed immunoreactivity for cytokeratin 20 and revealed negative staining for cytokeratin 7. These results confirmed the diagnosis of intestinal pri mary with ovarian metastasis, which was initially misdiagnosed as an ovaria n primary. Conclusion. Given the potential difficulty in determining the primary site of these tumors, immunohistochemistry proved to be a useful tool in reachin g the correct diagnosis, (C) 2000 Academic Press.