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Pathology of Malignancies Metastatic to the Ovary and of Synchronous Ovarian and Endometrial Carcinoma

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Pathology of the Ovary, Fallopian Tube and Peritoneum

Part of the book series: Essentials of Diagnostic Gynecological Pathology ((EDGP))

Abstract

Metastases to the ovary, particularly when mucinous, are treacherously difficult to distinguish from primary ovarian neoplasms. In routine clinical practice, this remains among the commonest and worst misdiagnoses in gynecological pathology and one that pathologists and clinicians alike can easily make. The error can have especially dire clinical consequences when metastasis from a silent extraovarian primary presents as an apparent low-stage ovarian carcinoma, but can equally be made, to the detriment of management, in an ovarian neoplasm with a known other primary.

Over the last three decades or so, a volume of literature has appeared emphasizing the features of primary and metastatic ovarian tumors for correct distinction. There are many general clinical, gross, and histological features that are helpful, apart from features specific to metastases from particular types and sites of primary tumor. Metastatic tumors tend to be bilateral, relatively small in size, and show surface involvement and vascular invasion, though exceptions occur. Some histological patterns, such as signet ring carcinoma, colloid carcinoma, and tumors associated with pseudomyxoma peritonei, are essentially exclusive to metastases. Specific tumor types are discussed individually in the chapter.

The vast majority of cases can be accurately diagnosed with due attention to morphological features, with or without the help of immunohistochemistry, and it is only a tiny minority whose true nature may not become apparent till after a period of clinical follow-up.

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Authors and Affiliations

  1. Department of Cellular Pathology, Barts Health NHS Trust, 80 Newark Street, London, E1 2ES, UK

    Naveena Singh MBBS, FRCPath

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  1. Naveena Singh MBBS, FRCPath
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Correspondence to Naveena Singh MBBS, FRCPath .

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  1. Department of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

    Nafisa Wilkinson

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Singh, N. (2014). Pathology of Malignancies Metastatic to the Ovary and of Synchronous Ovarian and Endometrial Carcinoma. In: Wilkinson, N. (eds) Pathology of the Ovary, Fallopian Tube and Peritoneum. Essentials of Diagnostic Gynecological Pathology. Springer, London. https://doi.org/10.1007/978-1-4471-2942-4_16

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