Hippokratia 2012, 16, 4: 391
Gavriilidis P¹, Ananiadis A¹, Theodoulidis V¹, Toskas I¹, Barbanis S²
1Department of Surgical Oncology, 2Department of Pathology, Theageneio Anticancer Hospital, Thessaloniki, Greece
Keywords: Ovarian metastasis, invasive ductal breast carcinoma, invasive lobular cancer, ovary tumour
Ovarian metastases are detected in 10%-20% of autopsies and 30% of therapeutic oophorectomy specimens from cases of breast carcinoma. Approximately 6%-7% of ovarian cancers and 10% of bilateral ovarian malignancies discovered during surgical intervention are metastatic1,2. Although invasive lobular carcinoma has a much greater tendency to metastasize to the ovary, 75% of ovarian metastases are from invasive ductal cancers due to its higher prevalence1-4.
We present the case of 53 years old female, who was admitted with the diagnosis of a perforated viscus. She underwent laparotomy and was indentified with solid multinodular masses on both ovaries. A Hartmann’s procedure, omentectomy and total hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology confirmed perforation of the inflamed sigmoid diverticulum, ovarian masses histologically demonstrated metastatic cancer from invasive intraductal Ca grade III, keratin (+), e-cadherin (+), ER (+), PR (+), c-erb2 (-), cytokeratin(-), chromogranin(-). The serosal layer of the body of the uterus was invaded by the same carcinoma.
Ovarian metastases can occur long after treatment for primary breast cancer, with intervals ranging from 1-19 years, during the interventions can be mistaken easily for an ovarian primary2. Attention to clinical history and macroscopic features and awareness of this possibility, can help in minimizing errors.
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