Abstract
Tumors that spread to the ovary from elsewhere are an important group of ovarian neoplasms because the misinterpretation of cases encountered as surgical pathology specimens may have significant adverse consequences for the patient. The spread may be from adjacent sites by direct local extension or from distant extragenital sites [27, 44, 61, 66, 90, 94, 111, 145, 152, 155, 161, 162]. The latter tumors are truly metastatic, whereas the designation “metastatic” is sometimes not used for those that are secondary from local sites. However, for simplicity, this discussion includes spread to the ovary from all sites.
References
Abdul-Hafeez M, Akhtar M, Aqeel HSB, Kidess EA (1987) Placental site trophoblastic tumor: report of a case with review of literature. Ann Saudi Med 7:340–344
Abu-Rustum NR, Barakat RR, Curtin JP (1997) Ovarian and uterine disease in women with colorectal cancer. Gynecol Oncol 89:85–87
Acosta-Sison H (1958) The relative frequency of various anatomic sites as the point of first metastasis in 32 cases of chorionepithelioma. Am J Obstet Gynecol 75:1149–1152
Agoff SN, Lamps LW, Philip AT, Amin MB, Schmidt RA, True LD, Folpe AL (2000) Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors. Mod Pathol 13:238–242
Amorn Y, Knight WA (1978) Primary linitis plastica of the colon: report of two cases and review of the literature. Cancer (Phila) 41:2420–2425
Baker PM, Clement PB, Young RH (2005) Malignant peritoneal mesothelioma in women. A study of 75 cases with emphasis on their morphologic spectrum and differential diagnosis. Am J Clin Pathol 123:724–737
Baker PM, Oliva E (2004) Immunohistochemistry as a tool in the differential diagnosis of ovarian tumors: an update. Int J Gynecol Pathol 24:39–55
Beck RP, Latour JPA (1963) Necropsy reports on 36 cases of endometrial carcinoma. Am J Obstet Gynecol 85:307–311
Berezowski K, Stastny JF, Kornstein MJ (1996) Cytokeratins 7 and 20 and carcinoembryonic antigen in ovarian and colonic carcinoma. Mod Pathol 9:426–429
Bhargava R, Beriwal S, Dabbs DJ (2007) Mammaglobin vs GCDFP-15. An immunohistologic validation survey for sensitivity and specificity. Am J Clin Pathol 127:103–113
Birnkrant A, Sampson J, Sugarbaker PH (1986) Ovarian metastasis from colorectal cancer. Dis Colon Rectum 29:767–771
Brogioni S, Viacava P, Tomisti L, Martino E, Macchia E (2007) A special case of bilateral metastases in a woman with papillary carcinoma of the thyroid. Exp Clin Endocrinol Diabetes 115:397–400
Brown BL, Scharifker DA, Gordon R, Deppe GG, Cohen CJ (1980) Bronchial carcinoid tumor with ovarian metastasis. A light microscopic and ultrastructural study. Cancer 46:543–546
Bullon A, Arseneau J, Prat J, Young RH, Scully RE (1981) Tubular Krukenberg tumor. A problem in histopathologic diagnosis. Am J Surg Pathol 5:225–232
Bunker ML (1959) The terminal findings in endometrial carcinoma. Am J Obstet Gynecol 77:530–538
Cameron RI, Ashe P, O’Rourke DM, Foster H, McCluggage WG (2003) A panel of immunohistochemical stains assists in the distinction between ovarian and renal clear cell carcinoma. Int J Gynecol Pathol 22:272–276
Carlson JW, Nucci MR, Brodsky J, Crum CP, Hirsch MS (2007) Biomarker-assisted diagnosis of ovarian, cervical and pulmonary small cell carcinomas: the role of TTF-1, WT-1 and HPV analysis. Histopathology 51:305–312
Caron P, Roche H, Gorguet B, Martel P, Bennet A, Carton M (1990) Mammary ovarian metastases with stromal cell hyperplasia and postmenopausal virilization. Cancer (Phila) 66:1221–1224
Che M, Tornos C, Deavers MT (2001) Ovarian mixed-epithelial carcinomas with a microcystic pattern and signet-ring cells. Int J Gynecol Pathol 20:323–328
Chen ZME, Wang HL (2004) Alteration of cytokeratin 7 and cytokeratin 20 expression profile is uniquely associated with tumorigenesis of primary adenocarcinoma of the small intestine. Am J Surg Pathol 28:1352–1359
Chu PG, Weiss LM (2004) Immunohistochemical characterization of signet-ring cell carcinomas of the stomach, breast, and colon. Am J Clin Pathol 121:884–892
Clement PB, Young RH, Scully RE (1996) Malignant mesotheliomas presenting as ovarian masses. A report of nine cases, including two primary ovarian mesotheliomas. Am J Surg Pathol 20:1067–1080
Creasman WT, Lukeman J (1972) Role of the fallopian tube in dissemination of malignant cells in corpus cancer. Cancer (Phila) 20:456–457
Curtin JP, Barakat RR, Hoskins WJ (1994) Ovarian disease in women with breast cancer. Obstet Gynecol 84:449–452
Daya D, Nazerali L, Frank GL (1992) Metastatic ovarian carcinoma of large intestinal origin simulating primary ovarian carcinoma. A clinicopathologic study of 25 cases. Am J Clin Pathol 97:751–758
DeCostanzo DC, Elias JM, Chumas JC (1997) Necrosis in 84 ovarian carcinomas: a morphologic study of primary versus metastatic colonic cancer with a selective immunohistochemical analysis of cytokeratin subtypes and carcinoembryonic antigen. Int J Gynecol Pathol 16:245–249
Demopoulos RI, Touger L, Dubin N (1987) Secondary ovarian carcinoma: a clinical and pathological evaluation. Int J Gynecol Pathol 6:166–175
Diddle AW (1955) Krukenberg tumors: diagnostic problem. Cancer (Phila) 8:1026–1034
DiLoreto C, Di Lauro V, Puglisi F et al (1997) Immunocytochemical expression of tissue specific transcription factor-1 in lung carcinoma. J Clin Pathol 50:30–32
Eichhorn JH, Young RH, Scully RE (1993) Non-pulmonary small cell carcinomas of extragenital origin metastatic to the ovary: a report of seven cases. Cancer (Phila) 71:177–186
Eifel P, Hendrickson M, Ross J, Ballon S, Martinez A, Kempson R (1982) Simultaneous presentation of carcinoma involving the ovary and the uterine corpus. Cancer (Phila) 50:163–170
Elhajj M, Mazurka J, Daya D (2002) Desmoplastic small round cell tumor presenting in the ovaries: report of a case and review of the literature. Int J Gynecol Cancer 12:760–763
Elishaev E, Gilks CB, Miller D, Srodon M, Kurman RJ, Ronnett BM (2005) Synchronous and metachronous endocervical and ovarian neoplasms. Evidence supporting interpretation of the ovarian neoplasms as metastatic endocervical adenocarcinomas simulating primary ovarian surface epithelial neoplasms. Am J Surg Pathol 29:281–294
Fitzgibbons PL, Martin SE, Simmons TJ (1987) Malignant melanoma metastatic to the ovary. Am J Surg Pathol 11:959–964
Gagnon Y, Tetu B (1989) Ovarian metastases of breast carcinoma. A clinicopathologic study of 59 cases. Cancer (Phila) 64:892–898
Gokden N, Gokden M, Phan DC, McKenney JK (2008) The utility of PAX-2 in distinguishing metastatic clear cell renal cell carcinoma from its morphologic mimics. An immunohistochemical study with comparison to renal cell carcinoma marker. Am J Surg Pathol 32:1462–1467
Goldblum J, Hart WR (1995) Localized and diffuse mesotheliomas of the genital tract and peritoneum in women. A clinicopathological study of nineteen true mesothelial neoplasms, other than adenomatoid tumors, multicystic mesotheliomas and localized fibrous tumors. Am J Surg Pathol 19:1124–1137
Graffner HOL, Alm POA, Oscarson JEA (1983) Prophylactic oophorectomy in colorectal carcinoma. Am J Surg 146:233–235
Green TH Jr, Scully RE (1962) Tumors of the fallopian tube. Clin Obstet Gynecol 5:886–906
Green LK, Silva EG (1989) Hepatoblastoma in an adult with metastasis to the ovaries. Am J Clin Pathol 92:110–115
Gupta D, Deavers MT, Silva EG et al (2004) Malignant melanoma involving the ovary. A clinicopathologic and immunohistochemical study of 23 cases. Am J Surg Pathol 28:771–780
Hale RW (1968) Krukenberg tumor of the ovaries. A review of 81 records. Obstet Gynecol 32:221–225
Harris M, Howell A, Chrissohou M, Swindell RIC, Hudson M, Sellwood RA (1984) A comparison of the metastatic pattern of infiltrating lobular carcinoma and infiltrating duct carcinoma of the breast. Br J Cancer 50:23–30
Hart WR (2005) Diagnostic challenge of secondary (metastatic) ovarian tumors simulating primary endometrioid and mucinous neoplasms. Pathol Int 55:321–343
Hassan R, Kreitman RJ, Pastan I, Willingham MC (2005) Localization of mesothelin in epithelial ovarian cancer. Mol Morphol 13:243–247
Hayashi Y, Kikuchi F, Oka T et al (1988) Rhabdomyosarcoma with bone marrow metastasis simulating acute leukemia. Report of two cases. Acta Pathol Jpn 38:789–798
Hecht JL, Pinkus JL, Weinstein LJ et al (2001) The value of thyroid transcription factor-1 in cytologic preparations as a marker for metastatic adenocarcinoma of lung origin. Am J Clin Pathol 116:483–488
Hines JR, Gordon RT, Widger C et al (1976) Cystosarcoma phyllodes metastatic to a Brenner tumor of the ovary. Arch Surg 111:299–300
Holtz F, Hart WR (1982) Krukenberg tumors of the ovary. A clinicopathologic analysis of 27 cases. Cancer (Phila) 50:2438–2447
Hopping RA, Dockerty MB, Masson JC (1942) Carcinoid tumor of the appendix. Report of a case in which extensive intra-abdominal metastases occurred, including involvement of the right ovary. Arch Surg 45:613–622
Hristov AC, Young RH, Vang R, Yemelyanova AV, Seidman JD, Ronnett BM (2007) Ovarian metastases of appendiceal tumors with goblet cell carcinoid-like and signet ring cell patterns: A report of 30 cases. Am J Surg Pathol 31:1502–1511
Hsiu J-G, Kemp GM, Singer GA, Rawls WH, Siddiky MA (1991) Transitional cell carcinoma of the renal pelvis with ovarian metastasis. Gynecol Oncol 41:178–181
Insabato L, DeRosa G, Franco R et al (2003) Ovarian metastasis from renal cell carcinoma: a report of three cases. Int J Surg Pathol 11:309–312
Irving JA, Lerwill MF, Young RH (2005) Gastrointestinal stromal tumors metastatic to the ovary. A report of five cases. Am J Surg Pathol 29:920–926
Irving JA, Vasques DR, McGuinness TB, Young RH (2006) Krukenberg tumor of renal pelvic origin: report of a case with selected comments on ovarian tumors metastatic from the urinary tract. Int J Gynecol Pathol 25:147–150
Irving JA, Young RH (2005) Lung carcinoma metastatic of the ovary. A clinicopathologic study of 32 cases emphasizing their morphologic spectrum and problems in differential diagnosis. Am J Surg Pathol 29:997–1006
Ji H, Isacson C, Seidman JD, Kurman RJ, Ronnett BM (2002) Cytokeratins 7 and 20, Dpc4, and MUC5AC in the distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors: Dpc4 assists in identifying metastatic pancreatic carcinomas. Int J Gynecol Pathol 21:391–400
Judson K, McCormick C, Vang R, Yemelyanova AV, Wu LSF, Bristow RE, Ronnett BM (2008) Women with undiagnosed colorectal adenocarcinomas presenting with ovarian metastases: Clinicopathologic features and comparison with women having known colorectal adenocarcinomas and ovarian involvement. Int J Gynecol Pathol 27:182–190
Kaminski PF, Norris HJ (1984) Coexistence of ovarian neoplasms and endocervical adenocarcinoma. Obstet Gynecol 64:553–556
Kanner WA, Galgano MT, Stoler MH, Mills SE, Atkins KA (2008) Distinguishing breast carcinoma from mullerian serous carcinoma with mammaglobin and mesothelin. Int J Gynecol Pathol 27:491–495
Karsh J (1951) Secondary malignant disease of the ovaries. A study of 72 autopsies. Am J Obstet Gynecol 61:154–160
Kaufmann O, Dietel M (2000) Thyroid transcription factor-1 is the superior immunohistochemical marker for pulmonary adenocarcinomas and large cell carcinomas compared to surfactant proteins A and B. Histopathology 36:8–16
Khunamornpong S, Lerwill MF, Siriaunkgul S, Suprasert P, Pojchamarnwiputh S, Chiangmai WN, Young RH (2008) Carcinoma of extrahepatic bile ducts and gallbladder metastatic to the ovary: a report of 16 cases. Int J Gynecol Pathol 27:366–379
Khunamornpong S, Siriaunkgul S, Chunduan A (1999) Metastatic hepatocellular carcinoma of the ovary. Int J Gynecol Obstet 64:189–191
Khunamornpong S, Siriaunkgul S, Suprasert P, Pojchamarnwiputh S, Chiangmai WN, Young RH (2007) Intrahepatic cholangiocarcinoma metastatic to the ovary: A report of 16 cases of an underemphasized form of secondary tumor of the ovary that may mimic primary neoplasia. Am J Surg Pathol 31:1788–1799
Khunamornpong S, Suprasert P, Chiangmai WN, Siriaunkgul S (2006) Metastatic tumors to the ovaries: a study of 170 cases in Northern Thailand. Int J Gynecol Cancer 16:132–138
Khunamornpong S, Suprasert PS, Pojchamarnwiputh S, Chiangmai WN, Settakorn J, Siriaunkgul S (2006) Primary and metastatic mucinous adenocarcinomas of the ovary: evaluation of the diagnostic approach using tumor size and laterality. Gynecol Oncol 101:152–157
Kim KR, Lee HI, Lee SK, Ro JY, Robboy SJ (2007) Is stromal microinvasion in primary mucinous ovarian tumors with “mucin granuloma” true invasion? Am J Surg Pathol 31:546–554
Kim K-R, Scully RE (1990) Peritoneal keratin granulomas with carcinomas of endometrium and ovary and atypical polypoid adenomyoma of endometrium. A clinicopathological analysis of 22 cases. Am J Surg Pathol 14:925–932
Kindelberger DW, Lee Y, Miron A, Hirsch MS, Feltmate C, Medeiros F, Callahan MJ, Garner EO, Gordon RW, Birch C, Berkowitz RS, Muto MG, Crum CP (2007) Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: evidence for a causal relationship. Am J Surg Pathol 31:161–169
Kiyokawa T, Young RH, Scully RE (2006) Krukenberg tumors of the ovary. A clinicopathologic analysis of 120 cases with emphasis on their variable pathologic manifestations. Am J Surg Pathol 31:277–299
Kubba LA, McCluggage WG, Liu J, Malpica A, Euscher ED, Silva EG, Deavers MT (2008) Thyroid transcription factor-1 expression in ovarian epithelial neoplasms. Mod Pathol 21:485–490
Kuo T-T, Hsueh S (1984) Mucicarminophilic histiocytosis. A polyvinylpyrrolidone (PVP) storage disease simulating signet-ring cell carcinoma. Am J Surg Pathol 8:419–428
Kurek R, Von Knoblock R, Feek U, Heidenreich A, Hofmann R (2001) Local recurrence of an oncocytic adrenocortical carcinoma with ovary metastasis. J Urol 166:985
Lash RH, Hart WR (1987) Intestinal adenocarcinomas metastatic to the ovaries. A clinicopathological evaluation of 22 cases. Am J Surg Pathol 11:114–121
Lee MJ, Lee HS, Kim WH, Choi Y, Yang M (2003) Expressions of mucins and cytokeratins in primary carcinomas of the digestive system. Mod Pathol 16:403–410
Lee AHS, Paish EC, Marchio C, Sapino A, Schmitt FC, Ellis IO, Reis-Filho JS (2007) The expression of Wilms’ tumour-1 and Ca125 in invasive micropapillary carcinoma of the breast. Histopathology 51:824–828
Lee KR, Young RH (2003) The distinction between primary and metastatic mucinous carcinomas of the ovary. Am J Surg Pathol 2:281–292
Leroy X, Farine MO, Buob D, Wacrenier A, Copin MC (2007) Diagnostic value of cytokeratin 7, CD10 and mesothelin in distinguishing ovarian clear cell carcinoma from metastasis of renal clear cell carcinoma. Histopathology 51:846–876
Lerwill MF (2004) Current practical applications of diagnostic immunohistochemistry in breast pathology. Am J Surg Pathol 28:1076–1091
Lerwill MF, Young RH (2006) 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 31:1382–1388
Lewis MR, Deavers MT, Silva EG, Malpica A (2006) Ovarian involvement by metastatic colorectal adenocarcinoma. Still a diagnostic challenge. Am J Surg Pathol 30:177–184
LiVolsi VA, Merino MJ, Schwartz PE (1983) Coexistent endocervical adenocarcinoma and mucinous adenocarcinoma of ovary: a clinicopathological study of four cases. Int J Gynecol Pathol 1:391–402
Logani S, Baloch ZW, Snyder PJ, Weinstein R, LiVolvi VA (2001) Cystic ovarian metastasis from papillary thyroid carcinoma: a case report. Thyroid 11:1073–1075
Logani S, Oliva E, Amin MB, Folpe AL, Cohen C, Young RH (2003) Immunoprofile of ovarian tumors with putative transitional cell (urothelial) differentiation using novel urothelial markers. Histogenic and diagnostic implications. Am J Surg Pathol 27:1434–1441
Logani S, Oliva E, Arnell PM, Amin MB, Young RH (2005) Use of novel immunohistochemical markers expressed in colonic adenocarcinoma to distinguish primary ovarian tumors from metastatic colorectal carcinoma. Mod Pathol 18:19–25
Longacre TA, O’Hanlan K, Hendrickson MR (1996) Adenoid cystic carcinoma of the submandibular gland with symptomatic ovarian metastases. Int J Gynecol Pathol 15:349–355
Lumb G, Mackenzie DH (1959) The incidence of metastases in adrenal glands and ovaries removed for carcinoma of the breast. Cancer (Phila) 12:521–526
MacKeigan JM, Ferguson JA (1979) Prophylactic oophorectomy and colorectal cancer in premenopausal patients. Dis Colon Rectum 22:401–405
Mazur MT, Hsueh S, Gersell DJ (1984) Metastases to the female genital tract. Analysis of 325 cases. Cancer (Phila) 53:1978–1984
McCluggage WG (2008) Immunohistochemical markers as a diagnostic aid in ovarian pathology. Diagn Histopathol 14:335–351
McCluggage WG, Bissonnette JP, Young RH (2006) Primary malignant melanoma of the ovary: A report of 9 definite or probable cases with emphasis on their morphologic diversity and mimicry of other primary and secondary ovarian neoplasms. Int J Gynecol Pathol 25:321–329
McCluggage WG, Wilkinson N (2005) Metastatic neoplasms involving the ovary: a review with an emphasis on morphological and immunohistochemical features. Histopathology 47:231–247
McCluggage WG, Young RH (2005) Immunohistochemistry as a diagnostic aid in the evaluation of ovarian tumors. Semin Diagn Pathol 22:3–32
McCluggage WG, Young RH (2008) Primary ovarian mucinous tumors with signet ring cells: report of three cases with discussion of so-called primary Krukenberg tumor. Am J Surg Pathol 32:1373–1379
McKenney JK, Soslow RA, Longacre TA (2008) Ovarian mature teratomas with mucinous epithelial neoplasms: Morphologic heterogeneity and association with pseudomyxoma peritonei. Am J Surg Pathol 32:645–655
Merino MJ, Edmonds P, LiVolsi V (1985) Appendiceal carcinoma metastatic to the ovaries and mimicking primary ovarian tumors. Int J Gynecol Pathol 4:110–120
Meyer WH, Yu GW, Milvenan ES, Jeffs RD, Kaizer H, Leventhal BG (1979) Ovarian involvement in neuroblastoma. Med Pediatr Oncol 7:49–54
Milingos D, Doumplis D, Savage P, Seckl M, Lindsay I, Smith JR (2007) Placental site trophoblastic tumor with an ovarian metastasis. Int J Gynecol Cancer 17:925–927
Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH (2003) Appendiceal mucinous neoplasms. A clinicopathologic analysis of 107 cases. Am J Surg Pathol 27:1089–1103
Monteagudo C, Merino MJ, Laporte N, Neumann RD (1991) Value of gross cystic disease fluid protein-15 in distinguishing metastatic breast carcinomas among poorly differentiated neoplasms involving the ovary. Hum Pathol 22:368–372
Moritani S, Ichihara S, Hasegawa M, Endo T, Oiwa M, Yoshikawa K, Sato Y, Aoyama H, Hayashi T, Kushima R (2008) Serous papillary adenocarcinoma of the female genital organs and invasive micropapillary carcinoma of the breast. Are WT1, CA125, and GCDFP-15 useful in differential diagnosis? Hum Pathol 39:666–671
Nguyen L, Brewer CA, DiSaia PJ (1998) Ovarian metastasis of Stage 1B1 squamous cell cancer of the cervix after radical parametrectomy and oophoropexy. Gynecol Oncol 68:198–200
Nonaka D, Chiriboga L, Soslow RA (2008) Expression of Pax8 as a useful marker in distinguishing ovarian carcinomas from mammary carcinomas. Am J Surg Pathol 32:1566–1571
Oberg KC, Wells K, Seraj IM et al (2002) ACTH-secreting islet cell tumor of the pancreas presenting as bilateral ovarian tumors and Cushing’s syndrome. Int J Gynecol Pathol 21:276–280
Ohira S, Shiohara S, Itoh K et al (2003) Urachal adenocarcinoma metastatic to the ovaries: case report and literature review. Int J Gynecol Pathol 22:189–193
Ohta Y, Suzuki T, Shiokawa A, Mitsuya T, Ota H (2005) Expression of CD10 and cytokeratins in ovarian and renal clear cell carcinoma. Int J Gynecol Pathol 24:239–245
Oliva E, Musulen E, Prat J, Young RH (1993) Transitional cell carcinoma of the renal pelvis with symptomatic ovarian metastases. Int J Surg Pathol 2:231–236
Onuma K, Dabbs DJ, Bhargava R (2008) Mammaglobin expression in the female genital tract: immunohistochemical analysis in benign and neoplastic endocervix and endometrium. Int J Gynecol Pathol 27:418–425
Parker LP, Duong JL, Wharton JT, Malpica A, Silva EG, Deavers MT (2002) Desmoplastic small round cell tumor: report of a case presenting as a primary ovarian neoplasm. Eur J Gynaec Oncol 23:199–202
Petru E, Pickel H, Heydarfadai M, Lahousen M, Haas J, Schaider H, Tamussino K (1992) Nongenital cancers metastatic to the ovary. Gynecol Oncol 44:83–86
Phillips V, McCluggage WG, Young RH (2006) Oxyphilic adenomatoid tumor of the ovary: a case report with discussion of the differential diagnosis of ovarian tumors with vacuoles and related spaces. Int J Gynecol Pathol 26:16–20
Pins MR, Young RH, Crum CP, Leach IH, Scully RE (1997) Cervical squamous carcinoma in situ with superficial extension to corpus and tubes and invasion of tubes and ovaries. Int J Gynecol Pathol 16:272–278
Pitluk H, Poticha SM (1983) Carcinoma of the colon and rectum in patients less than 40 years of age. Surg Gynecol Obstet 157:335–337
Pitman MB, Triratanachat S, Young RH, Oliva E (2003) Hepatocyte paraffin 1 antibody does not distinguish primary ovarian tumors with hepatoid differentiation from metastatic hepatocellular carcinoma. Int J Gynecol Pathol 23:58–64
Prayson RA, Hart WR, Petras RE (1994) Pseudo-myxoma peritonei. A clinicopathologic study of 19 cases with emphasis on site of origin and nature of associated ovarian tumors. Am J Surg Pathol 18:591–603
Rabban JT, Lerwill MF, McCluggage WG, Grenert JP, Zaloudek CJ (2009) Primary ovarian carcinoid tumors may express CDX-2: a potential pitfall in distinction from metastatic intestinal carcinoid tumors involving the ovary. Int J Gynecol Pathol 28:41–48
Reis-Filho JS, Carrilho C, Valenti C et al (2000) Is TTF1 a good immunohistochemical marker to distinguish primary from metastatic lung adenocarcinomas? Pathol Res Pract 196:835–840
Riopel MA, Ronnett BM, Kurman RJ (1999) Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors. Atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas. Am J Surg Pathol 23:617–635
Robboy SJ, Scully RE, Norris HJ (1974) Carcinoid metastatic to the ovary. A clinicopathologic analysis of 35 cases. Cancer (Phila) 33:798–811
Ronnett BM, Kurman RJ, Shmookler BM, Sugarbaker PH, Young RH (1997) The morphologic spectrum of ovarian metastases of appendical 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 2:1144–1155
Ronnett BM, Kurman RJ, Zahn CM, Shmookler BM, Jablonski KA, Kass ME (1995) Pseudomyxoma peritonei in women. A clinicopathologic analysis of 30 cases with emphasis on site of origin, prognosis, and relationship to ovarian mucinous tumors of low malignant potential. Hum Pathol 26:509–524
Ronnett BM, Shmookler BM, Diener-West M, Sugarbaker PH, Kurman RJ (1997) Immunohistochemical evidence supporting the appendiceal origin of pseudomyxoma peritonei in women. Int J Gynecol Pathol 16:1–9
Ronnett BM, Yemelyanova AV, Vang R, Gilks CB, Miller D, Gravitt PE, Kurman RJ (2008) 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 32:1835–1853
Ronnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM (1995) Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol 19:1390–1408
Saphir O (1951) Signet-ring cell carcinoma. Mil Surg 109:360–369
Sasaki E, Tsunoda N, Hatanaka Y, Mori N, Iwata H, Yatabe Y (2007) Breast-specific expression of MGB1/mammaglobin: an examination of 480 tumors from various organs and clinicopathological analysis of MGB1-positive breast cancers. Mod Pathol 20:208–214
Scully RE, Richardson GS (1961) Luteinization of the stroma of metastatic cancer involving the ovary and its endocrine significance. Cancer (Phila) 14:827–840
Seidman JD, Elsayed AM, Sobin LH, Tavassoli FA (1993) Association of mucinous tumors of the ovary and appendix. A clinicopathologic study of 25 cases. Am J Surg Pathol 17:22–34
Seidman JD, Kurman RJ, Ronnett BM (2003) Incidence in routine practice with a new approach to improve intraoperative diagnosis. Primary and metastatic mucinous adenocarcinomas in the ovaries. Am J Surg Pathol 27:985–993
Smale L (1980) Metastatic breast adenocarcinoma to Brenner tumors. Gynecol Oncol 9:251–253
Soslow RA, Rouse RV, Hendrickson MR, Silva EG, Longacre TA (1996) Transitional cell neoplasms of the ovary and urinary bladder: a comparative immunohistochemical analysis. Int J Gynecol Pathol 15:257–265
Spencer JR, Eriksen B, Garnett JE (1993) Metastatic renal tumor presenting as ovarian clear cell carcinoma. Urology 41:582–584
Stewart CJR, Brennan BA, Hammond IG et al (2005) Accuracy of frozen section in distinguishing primary ovarian neoplasia from tumors metastatic to the ovary. Int J Gynecol Pathol 24:356–362
Strosberg J, Nasir A, Cragun J, Gardner N, Kvols L (2007) Metastatic carcinoid tumor to the ovary: a clinicopathologic analysis of seventeen cases. Gynecol Oncol 106:65–68
Sty JR, Kun LE, Casper JT (1980) Bone scintigraphy in neuroblastoma with ovarian metastasis. Wis Med J 79:28–29
Szych C, Staebler A, Connolly DC, Wu R, Cho KR, Ronnett BM (1999) Molecular genetic evidence supporting the clonality and appendiceal origin of pseudomyxoma peritonei in women. Am J Pathol 154:1849–1855
Tabata M, Ichinoe K, Sakuragi N, Shina Y, Yamaguchi T, Mabuchi Y (1987) Incidence of ovarian metastasis in patients with cancer of the uterine cervix. Gynecol Oncol 28:255–261
Tang LH, Shia J, Soslow RA, Dhall D, Wong WD, O’Reilly E, Qin J, Paty P, Weiser MR, Guillem J, Temple L, Sobin LH, Klimstra DS (2008) Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol 32:1429–1443
Toki N, Tsukamoto N, Kaku T et al (1991) Microscopic ovarian metastasis of the uterine cervical cancer. Gynecol Oncol 41:46–51
Tornos C, Soslow R, Chen S et al (2005) Expression of WT1, CA 125, and GCDFP-15 as useful markers in the differential diagnosis of primary ovarian carcinomas versus metastatic breast cancer to the ovary. Am J Surg Pathol 29:1482–1489
Tso PL, Bringaze WL III, Dauterive AH, Correa P, Cohn I Jr (1987) Gastric carcinoma in the young. Cancer (Phila) 59:1362–1365
Ulbright TM, Roth LM (1985) Metastatic and independent cancers of the endometrium and ovary: a clinicopathologic study of 34 cases. Hum Pathol 16:28–34
Ulbright TM, Roth LM (1985) Secondary tumors of the ovary. In: Roth LM, Czernobilsky B (eds) Tumors and tumor-like conditions of the ovary, vol 6, Contemporary issues in surgical pathology. Churchill-Livingstone, New York, pp 129–152
Ulbright TM, Roth LM, Stehman FB (1984) Secondary ovarian neoplasia. A clinicopathologic study of 35 cases. Cancer (Phila) 53:1164–1174
Vakiani E, Young RH, Carcangiu ML, Klimstra DS (2008) Acinar cell carcinoma of the pancreas metastatic to the ovary. A report of 4 cases. Am J Surg Pathol 32:1540–1545
Vang R, Gown AM, Barry TS, Wheeler DT, Yemelyanova A, Seidman JD, Ronnett BM (2006) Cytokeratins 7 and 20 in primary and secondary mucinous tumors of the ovary: analysis of coordinate immunohistochemical expression profiles and staining distribution in 179 cases. Am J Surg Pathol 30:1130–1139
Vang R, Gown AM, Wu LSF, Barry TS, Wheeler DT, Yemelyanova A, Seidman JD, Ronnett BM (2006) Immunohistochemical expression of CDX2 in primary ovarian mucinous tumors and metastatic mucinous carcinomas involving the ovary: comparison with CK20 and correlation with coordinate expression of CK7. Mod Pathol 19:1421–1428
Vang R, Gown AM, Zhao C, Barry TS, Isacson C, Richardson MS, Ronnett BM (2007) Ovarian mucinous tumors associated with mature cystic teratomas. Morphologic and immunohistochemical analysis identifies a subset of potential teratomatous origin that shares features of lower gastrointestinal tract mucinous tumors more commonly encountered as secondary tumors in the ovary. Am J Surg Pathol 31:854–869
Vara A, Madrigal B, Veiga M, Diaz A, Garcia J, Calvo J (1998) Bilateral ovarian metastases from renal clear cell carcinoma. Acta Oncol (Stockh) 37:379–380
Veras E, Srodon M, Neijstrom ES, Ronnett BM (2009) Metastatic HPV-related cervical adenocarcinomas presenting with thromboembolic events (Trousseau syndrome): clinicopathologic characteristics of two cases. Int J Gynecol Pathol 28:134–139
Webb MJ, Decker DG, Mussey E (1975) Factors influencing survival. Cancer metastatic to the ovary. Obstet Gynecol 45:391–396
Wheelock MC, Putong P (1959) Ovarian metastases from adenocarcinomas of colon and rectum. Obstet Gynecol 14:291–295
Wick MR, Lillemoe TJ, Copland GT, Swanson PE, Manivel JC, Kiang DT (1989) Gross cystic disease fluid protein-15 as a marker for breast cancer: immunohistochemical analysis of 690 human neoplasms and comparison with alpha-lactalbumin. Hum Pathol 20:281–287
Woodruff JD, Murthy YS, Bhaskar TN, Bordbar F, Tseng S-S (1970) Metastatic ovarian tumors. Am J Obstet Gynecol 107:202–209
Yakushiji M, Tazaki T, Nishimura H, Kato T (1987) Krukenberg tumors of the ovary: a clinicopathologic analysis of 112 cases. Acta Obstet Gynaecol Jpn 39:479–485
Yemelyanova AV, Vang R, Judson K, Wu LSF, Ronnett BM (2008) Distinction of primary and metastatic mucinous tumors involving the ovary: analysis of size and laterality data by primary site with reevaluation of an algorithm for tumor classification. Am J Surg Pathol 32:128–138
Yoshida A, Shigematsu T, Mori H, Yoshida H, Fukunishi R (1981) Non-invasive thymoma with widespread blood-borne metastasis. Virchows Arch (Path Anat) 390:121–126
Young RH (1995) Urachal adenocarcinoma metastatic to the ovary simulating primary mucinous cystadenocarcinoma of the ovary: report of a case. Virchows Arch 426:529–532
Young RH (2004) Pseudomyxoma peritonei and selected other aspects of the spread of appendiceal neoplasms. Semin Diagn Pathol 21:134–150
Young RH (2006) From Krukenberg to today: The ever present problems posed by metastatic tumors in the ovary. Part I. Historical perspective, general principles, mucinous tumors including the Krukenberg tumor. Adv Anat Pathol 13:205–227
Young RH (2007) From Krukenberg to today: the ever present problems posed by metastatic tumors in the ovary. Part II. Adv Anat Pathol 14:149–177
Young RH, Carey RW, Robboy SJ (1981) Breast carcinoma masquerading as a primary ovarian neoplasm. Cancer (Phila) 48:210–212
Young RH, Eichhorn JH, Dickersin GR, Scully RE (1992) Ovarian involvement by the intra-abdominal desmoplastic small round cell tumor with divergent differentiation. A report of three cases. Hum Pathol 23:454–464
Young RH, Gersell DJ, Clement PB, Scully RE (1992) Hepatocellular carcinoma metastatic to the ovary: a report of three cases discovered during life with discussion of the differential diagnosis of hepatoid tumors of the ovary. Hum Pathol 23:574–580
Young RH, Gersell DJ, Roth LM, Scully RE (1993) Ovarian metastases from cervical carcinomas other than pure adenocarcinomas: a report of 12 cases. Cancer (Phila) 71:407–418
Young RH, Gilks CB, Scully RE (1991) Mucinous tumors of the appendix associated with mucinous tumors of the ovary and pseudomyxoma peritonei: a clinicopathological analysis of 22 cases supporting an origin in the appendix. Am J Surg Pathol 15:415–429
Young RH, Hart WR (1989) Metastases from carcinomas of the pancreas simulating primary mucinous tumors of the ovary: a report of seven cases. Am J Surg Pathol 13:748–756
Young RH, Hart WR (1992) Renal cell carcinoma metastatic to the ovary: a report of three cases emphasizing possible confusion with ovarian clear cell adenocarcinoma. Int J Gynecol Pathol 11:96–104
Young RH, Hart WR (1998) Metastatic intestinal carcinomas simulating primary ovarian clear cell carcinoma and secretory endometrioid carcinoma. A clinicopathologic and immunohistochemical study of five cases. Am J Surg Pathol 22:805–815
Young RH, Jackson A, Wells M (1994) Ovarian metastasis from thyroid carcinoma twelve years after partial thyroidectomy mimicking struma ovarii. Report of a case. Int J Gynecol Pathol 13:181–185
Young RH, Kozakewich HPW, Scully RE (1993) Metastatic ovarian tumors in children: a report of 14 cases and review of the literature. Int J Gynecol Pathol 12:8–19
Young RH, Prat J, Scully RE (1984) Endometrial stromal sarcomas of the ovary. A clinicopathologic analysis of 23 cases. Cancer (Phila) 53:1143–1155
Young RH, Scully RE (1985) Ovarian metastases from cancer of the lung: problems in interpretation – a report of seven cases. Gynecol Oncol 21:337–350
Young RH, Scully RE (1988) Mucinous tumors of the ovary associated with mucinous adenocarcinomas of the cervix. A clinicopathological analysis of 16 cases. Int J Gynecol Pathol 7:99–111
Young RH, Scully RE (1988) Urothelial and ovarian carcinomas of identical cell types: problems in interpretation. A report of three cases and review of the literature. Int J Gynecol Pathol 7:197–211
Young RH, Scully RE (1989) Alveolar rhabdomyosarcoma metastatic to the ovary. A report of two cases and discussion of the differential diagnosis of small cell malignant tumors of the ovary. Cancer (Phila) 64:899–904
Young RH, Scully RE (1990) Ovarian metastases from carcinoma of the gallbladder and extrahepatic bile ducts simulating primary tumors of the ovary: a report of six cases. Int J Gynecol Pathol 9:60–72
Young RH, Scully RE (1990) Sarcomas metastatic to the ovary. A report of 21 cases. Int J Gynecol Pathol 9:231–252
Young RH, Scully RE (1991) Malignant melanoma metastatic to the ovary: a clinicopathologic analysis of 20 cases. Am J Surg Pathol 15:849–860
Young RH, Scully RE (1991) Metastatic tumors in the ovary: a problem-oriented approach and review of the recent literature. Semin Diagn Pathol 8:250–276
Young RH, Scully RE (2001) Differential diagnosis of ovarian tumors based primarily on their patterns and cell types. Semin Diagn Pathol 18:161–235
Yu TJ, Iwasaki I, Horie H, Tamaru J, Takahashi A (1986) Endolymphatic stromal myosis of the uterus with metastasis to ovary and recurrence in vagina. Acta Pathol Jpn 36:301–308
Zaino RJ, Unger ER, Whitney C (1984) Synchronous carcinomas of the uterine corpus and ovary. Gynecol Oncol 19:329–335
Zaloudek C, Miller TR, Stern JL (1995) Desmoplastic small cell tumor of the ovary: a unique polyphenotypic tumor with an unfavorable prognosis. Int J Gynecol Oncol 14:260–265
Zamecnik M, Voltr L, Stuk J, Chlumska A (2008) Krukenberg tumor with yolk sac tumor differentiation. Int J Gynecol Pathol 27:223–228
Zhang PJ, Gao HG, Pasha TL, Litzky L, LiVolsi V (2009) TTF-1 expression in ovarian and uterine epithelial neoplasia and its potential significance, an immunohistochemical assessment with multiple monoclonal antibodies and different secondary detection systems. Int J Gynecol Pathol 28:10–18
Zukerberg LR, Young RH (1990) Chordoma metastatic to the ovary: report of a case. Arch Path Lab Med 114:208–210
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this entry
Cite this entry
Lerwill, M.F., Young, R.H. (2011). Metastatic Tumors of the Ovary. In: Kurman, R.J., Ellenson, L.H., Ronnett, B.M. (eds) Blaustein’s Pathology of the Female Genital Tract. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-0489-8_18
Download citation
DOI: https://doi.org/10.1007/978-1-4419-0489-8_18
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-0488-1
Online ISBN: 978-1-4419-0489-8
eBook Packages: MedicineReference Module Medicine