Introduction/Background*Management of a pelvic mass is a common cause of surgery among women. In nearly 20% of cases, such masses represent primary ovarian malignancies, treated with complete surgical staging. However, in 6-7% of cases, the ovarian malignancy will present as a metastatic lesion form other sites, known as Krukenberg tumors. This term usually characterizes primary gastric cancer, but Krukenberg tumors can also arise from other primary sites. In the present study we assessed the characteristics of metastatic tumors to the ovaries from non-genital tract primary sites and attempted to determine the route of tumor spread.
Methodology We retrospectively reviewed medical records of patients whose indication for surgery was a pelvic mass from January 2000 to December 2018. The study was conducted after approval of the Institutional Review Board. Reports and medical files were reviewed for age at diagnosis, tumor size, laterality of metastasis and primary tumor site. Only patients with metastatic disease to the ovary were included in the study.
Result(s)*A total of 64 cases of metastasis to the ovary were identified. The median age the patients was 58 years old (range: 28 – 81). Primary gastric cancer was identified in 28 (43.9%) cases; breast cancer 14 (21.9%) and colon cancer 13 (20.3%). Pancreatic cancer and urinary bladder each contributed 3 (4.7%) cases, while b-cells lymphoma, primary peritoneal cancer and lung cancer each recorded 1 (1.5%) case. In most cases bilateral disease was present (43 cases, 67.2%), while surface involvement was recorded in 55 patients (86%). Survival data existed only for a subset of 15 patients with median overall survival of 23.7 months (95%CI12.7-34.8).
Conclusion*Metastatic ovarian cancer is more usually seen from primary gastric, breast and colon cancer. Hematogenous spread appears a more common route in these cases, rather than transserosal pathway. Despite survival data were limited in a subset of patients, data indicate the presence of long-term survivors. Analysis of larger datasets is warranted to optimize surgical and medical treatment in patients with metastatic disease to the ovary.
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