Irving JA, Young RH. Lung carcinoma metastatic to the ovary. A clinicopathologic study of 32 cases emphasizing their morphologic spectrum and problems in differential diagnosis

Department of Pathology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
American Journal of Surgical Pathology (Impact Factor: 5.15). 09/2005; 29(8):997-1006.
Source: PubMed


Thirty-two cases of lung carcinoma metastatic to the ovary in women 26 to 76 years of age (mean, 47 years) are reported. A history of prior lung carcinoma was documented in 53% of cases (17 of 32), with the ovarian tumor detected at a mean interval of 1 year. In 10 cases (31%), the lung and ovarian tumors occurred synchronously, and in 5 (16%) the ovarian tumor was detected up to 26 months before the lung cancer. Small cell carcinoma was more likely to present with ovarian manifestations than other subtypes. A history of smoking was obtained in 9 cases (28%), but detailed histories were not always available and the figure may be spuriously low. Forty-four percent of the tumors were small cell carcinomas (14 of 32), 34% adenocarcinomas (11 of 32), and 16% large cell carcinomas (5 of 32); there was a single squamous cell carcinoma and one atypical carcinoid. Thirteen percent of cases (4 of 32) had a coexisting primary ovarian tumor. The mean ovarian tumor size was 9.7 cm, and one third of the ovarian metastases were bilateral. Tumor was limited to the lung and one or both ovaries in 13 cases (40%). Morphologic features common to many of the ovarian tumors were multinodular growth, widespread necrosis, and extensive lymphovascular invasion; involvement of the ovarian surface was rare. Attention to these features, to the usual absence of associated typical surface epithelial neoplasia, and to the clinical history enabled the correct diagnosis to be made in the majority of cases without need of special studies. In a minority of cases, immunohistochemical staining for thyroid transcription factor-1 was a useful ancillary marker in the distinction from primary ovarian carcinoma. The differential diagnosis with the primary ovarian tumors most often meriting consideration, including unusual variants of surface epithelial tumors, is discussed.

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    • "Because of its rarity, it was not found in some reports of primary cancers causing metastatic ovarian cancers. In a large study, lung cancer comprised about 0.4% of metastatic ovarian cancer origins [7]. "
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    ABSTRACT: Metastatic ovarian cancer is not an uncommon finding. Such tumors almost always originate from female genital tract, colon, stomach, or breast. Lung cancer is not a common origin of ovarian metastases. Of all metastatic ovarian tumors, approximately 0.3% arise from lung cancer. Ovarian torsion is not an uncommon finding, but ovarian torsion with cancer is rare. Here, we report a 44-year-old woman who was previously diagnosed with advanced stage lung cancer and who emergently visited our hospital for abdominal pain. An imaging work-up revealed, ovarian torsion and exploratory laparotomy was performed. Pathological examination led to the diagnosis ovarian metastasis from lung cancer. This is the first case of ovarian metastasis from lung cancer, ovarian torsion.
    09/2013; 56(5):341-344. DOI:10.5468/ogs.2013.56.5.341
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    • "Such frequency, however, is increasing due to rising incidence of lung cancer in women [2]. So far, forty cases are been reported of lung cancer metastatic to the ovary in an age range of 26 to 76 years [2,10-16]. Small cell carcinoma and adenocarcinoma were more likely to present with ovarian manifestations than other subtypes (small cell carcinoma: 45% (18 of 40); adenocarcinoma: 32.5% (13 of 40); large cell carcinoma: 12.5% (5 of 40); and 2.5% (1 of 40) for squamous cell carcinoma, atypical carcinoid, bronchiole-alveolar carcinoma, and pulmonary blastoma). A prior lung carcinoma was documented in more than half of cases, the lung and ovarian tumors occurred synchronously in one third, and only in the remaining cases, cancer was first detected in the ovary and then in the lung. "
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    ABSTRACT: Metastatic neoplasms to the ovary often cause diagnostic problems, in particular those large ovarian masses mimicking primary tumors. Most of these tumors arise from digestive system or breast, while 37-year-old woman diagnosed as right adnexal complex mass, with a subpleural nodule in the apical part of the left lower lobe, at preoperative chest computed tomography scan. The patient underwent total abdominal hysterectomy with right salpingo-oophorectomy (ovarian mass 220 × 200 mm), total omentectomy, left ovarian biopsy, peritoneal random biopsies, and peritoneal washings for cytology. Pathologic and immunohistochemical examination of ovarian specimen suggested morphology and expression of metastatic lung adenocarcinoma with an intense positivity for Thyroid Transcriptional Factor-1 (TTF-1) and Cytokeratin 7 (CK7) staining. Fine needle biopsy of the lung nodule found epithelioid like malignant cells, confirming the diagnosis of an ovarian metastasis from a primary lung cancer. This report focused on the clinical and pathologic diagnostic challenge of distinguishing secondary from primary ovarian neoplasms. Issues on useful immunohistochemical stains are also discussed.
    Journal of Ovarian Research 05/2013; 6(1):34. DOI:10.1186/1757-2215-6-34 · 2.43 Impact Factor
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    • "that the clinical characteristics and pathological features of the disease may be useful in the diagnosis of ovarian metastasis from lung cancer. Irving and Young [6] "
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    ABSTRACT: This paper describes a case of ovarian metastasis from lung carcinoma along with its diagnostic challenges, clinical management, and review of the literature. A 49-year-old woman was admitted to our emergency department with complaints of abdominal pain and vomiting. A laparoscopic appendectomy was performed due to acute appendicitis, and a unilateral oophorectomy (left side) via laparoscopy was performed due to the detection of an ovarian mass. Immunohistochemical staining of the ovarian mass revealed that it was reactive to cytokeratin-7 (CK-7) but negative for CK-20. The immunohistochemical and pathological features of the tumor indicated an ovarian metastasis of non-small-cell lung cancer. The patient underwent chemotherapy and was followed up by the oncology department. Her postoperative regular followup of 6 months showed that her condition was stable with no recurrence. The management of female patients with acute abdominal pain and pelvic masses should consist of a multidisciplinary approach to include the diagnosis of any distant organ metastasis.
    03/2013; 2013:378438. DOI:10.1155/2013/378438
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