Ovarian metastases

Ronnett BM, Kurman RJ, Shmookler BM, et al. The morphologic spectrum of ovarian metastases of appendiceal adenocarcinomas a clinicopathologic and immunohistochemical analysis of tumors often misinterpreted as primary ovarian tumors or metastatic tumors from other gastrointestinal sites. Am J Surg Pathol. 1997 21 1144-1155. 

Lagendijk JH, Mullink H, Van Diest PJ, et al. Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach. J Clin Pathol. 1999 52 283-290. 

Lerwill ME, Young RH. Ovarian metastases of intestinal-type gastric carcinoma A clinicopathologic study of 4 cases with contrasting features to those of the Krukenberg tumor. Am J Surg Pathol. 2006 30 1382-1388. 

Gagnon Y, Tetu B. Ovarian metastases of breast carcinoma. A clinicopathologic study of 59 cases. Cancer. 1989 64 892-898. 

Ronnett BM, Yemelyanova AV, Vang R, et al. Endocervical adenocarcinomas with ovarian metastases Analysis of 29 cases with emphasis on minimally invasive cervical tumors and the ability of the metastases to simulate primary ovarian neoplasms. Am J Surg Pathol. 2008 32 1835-1853. 

Ovarian metastases are often asymptomatic. They may rarely even precede the primary neoplasm. In general, ovarian metastases are associated with a poor prognosis and the majority of patients will die within the first year after detection [54]. 

Confident distinction between primary and metastatic ovarian cancers is not possible because of overlapping findings in imaging. Bilateral, sharply delineated, purely solid or predominantly solid tumors with necrosis strongly favor the diagnosis of a metastatic ovarian tumor, most likely Krukenberg tumors [68]. Contrast uptake aids in the differentiation of solid ovarian metastases from stromal tumors. Stromal tumors typically display a mild and delayed contrast uptake [69]. If metastases are cystic... 

Lundstedt C, Holmin T, Thorvinger B (1992) Peritoneal ovarian metastases simulating liver parenchymal masses. Gas-trointest Radiol 17 250-252... 

Ovarian cancer usually is confined to the abdominal cavity, but spread can occur to the lung, liver, and less commonly, bone or brain. Disease is spread by direct extension, peritoneal seeding, lymphatic dissemination, and blood-borne metastasis. 

Blood vessels penetrating tumors provide malignant cells with another point at which to enter the circulation. Evidence exists that in situation where cancers disseminate predominantly by the blood, the extent of metastasis depends upon the vasculature of the primary tumor. Thin-walled capillaries, especially those newly formed, provide poor resistance to invading cancer cells. Also, data from microscopy studies show that the endothelium of tumor vessels, particularly in areas of poor oxygenation, is often abnormal (Kl). These abnormalities may permit invasion by neoplastic cells (P3). Finally, tumors can spread by direct extension into body cavities such as pleural and peritoneal spaces. An example of this is the formation of peritoneal metastases from ovarian carcinoma. 

Variations on the filter-based assay have been designed to approximate more physiological contexts. Such assays include tumor cell invasion across a confluent cell monolayer (e.g., endothelial cells (EC) as a surrogate for intravasation or extravasation during hematogenous metastasis (24)) and ovarian carcinoma invasion of mesothelial cell monolayers (25). Additionally, 1 mm thick slices of human brain tissue have been used as a tissue barrier on Transwell filters with invasion of GFP-labeled glioma cells measured by confocal microscopy (26). 

Burleson KM, Hansen LK, Skubitz AP (2004) Ovarian carcinoma spheroids disaggregate on type I collagen and invade live human meso-thelial cell monolayers. Clin Exp Metastasis 21 685-697... 

Hirashima Y, Suzuki M, Kobayashi H. Suppression of cancer invasion and metastasis in human ovarian cancer cells transfected with UTI gene. Surg Trauma Immunol Respon 2001 10 30-36. 

Anderson, K., Lawson, K. A., Simmons-Menchaca, M., Sun, L., SAnders, B. G., and Kline, K. (2004), a-TEA plus cisplatin reduces human cisplatin-resistant ovarian cancer cell tumor burden and metastasis, Exp. Biol. Med., 229,1169-1176. 

Fig. 37.21 Pronounced peritoneal metastasis (with simultaneous liver metastases) in ovarian carcinoma...

MMPs also act as predictors of recurrence or metastatic risk. High preoperative serum levels of MMP-2 or MMP-3 are predictive of recurrence in patients with advanced urotheliai carcinoma. Furthermore, high levels of MMP-2 in ovarian tumor cells can predict tumor recurrence. The expression of certain MMPs is predictive of metastatic risk. For example, expression of MMP-1 is associated with lymph node metastasis in cervical and peritoneal metastasis in gastric cancer. MMP inhibition may be a therapeutic strategy for cancer. ... 

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