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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinicopathologic findings of 13 patients with ovarian pure germinomas (dysgerminomas) were studied to assess modes of therapy. The patients' ages ranged from 12 to 40 years. Ten patients had unilateral tumors clinically confined to the ovary (Stage I), including 1 patient who had an unsuspected microscopic germinoma in a normal-appearing ovary. Of those with Stage I tumors, only 1 patient developed metastases and died; however, the presence of other elements in the mestases suggested that her primary ovarian neoplasm actually may have been a malignant mixed germ cell tumor. The other 9 patients are alive without tumor after postoperative intervals of 0.3 to 29 years. Three patients had more advanced lesions (Stages II-IV) and 2 died of metastases following orthovoltage irradiation. The results of this study support the concept of individualized therapy for patients with ovarian germinomas.
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PMID:Ovarian germinomas (dysgerminomas). 62 36

Lymphangiography can be of assistance in pre-treatment staging and thereby influence management of patients with ovarian cancer. The distribution of lymph node metastases was related to the histologic type of ovarian neoplasm. Tumors of germ cell origin more frequently spread to para-aortic lymph nodes, while epithelial neoplasms of the ovary metastasized to the pelvic and para-aortic lymph nodes, apparently in continuity. In this series, lymph node metastasis from ovarian cancer was seldom associated with ascites.
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PMID:Lymphangiography in ovarian cancer. 111 44

Ovarian involvement from extragenital cancer often presents clinically as probable primary ovarian neoplasm. A retrospective review of the 29 such cases at Parkland Memorial Hospital from 1962 to 1985 was analyzed looking at clinical, surgical, and pathological parameters. The most frequent primary sites were colon (52%), breast (17%), stomach (10%), and pancreas (10%). Most common presenting symptoms were abdominal pain in 48% and increased abdominal girth in 45%. Preoperatively a palpable pelvic mass was detected in 93% and clinical ascites in 41% of patients. At surgery only 20% of patients had isolated ovarian metastases. Abdominal exploration identified the original tumor in 84% of the cases in which the primary originated in the abdomen. Bilateral ovarian involvement was found in 60%, and in 33% of these the contralateral involvement was occult. Eighty-three percent of patients have died with a median survival of 6 months. We conclude that mode of presentation, physical findings, and intraoperative assessment of patients with secondary ovarian neoplasms are no different from primary ovarian malignancy, and that when evaluating a pelvic mass, consideration should always be given to the possibility of secondary ovarian neoplasms.
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PMID:Ovarian involvement in extragenital cancer. 273 34

The most common secondary ovarian neoplasm to mimic an ovarian primary tumor is metastatic large intestinal adenocarcinoma. Even after histologic examination, metastases often are mistaken for primary adenocarcinomas, especially endometrioid carcinoma. We analyzed the clinical and pathologic features of 22 cases of documented large intestinal carcinoma metastatic to the ovary. Patients' ages ranged from 42 to 76 years. None of the intestinal primary tumors were Dukes stage A, 32% were Dukes B, and 68% were Dukes C. In nine patients (41%), the intestinal carcinomas had been resected previously from 4 to 60 months before removal of the ovarian metastases. Both ovaries were involved in 43% of the cases. Histologically, 19 cases were classified as pseudoendometrioid type, two as mucinous type, and one as mixed pseudoendometrioid-mucinous type. The most characteristic microscopic features of the ovarian metastases were garland and cribriform growth patterns, intraluminal "dirty" necrosis, segmental destruction of glands, and absence of squamous metaplasia. Special stains for mucosubstances were variable and not helpful in differential diagnosis. Immunohistochemical staining for carcinoembryonic antigen (CEA) was strongly positive. Recognition of these distinctive histologic features is crucial to proper identification of the intestinal origin of these ovarian tumors. Inappropriate treatment as primary ovarian carcinomas thereby is avoided, and more accurate assessment of prognosis is achieved.
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PMID:Intestinal adenocarcinomas metastatic to the ovaries. A clinicopathologic evaluation of 22 cases. 381 71

Twelve cases of ovarian metastases from cervical carcinomas, most with clinical manifestations of ovarian involvement, are reported. The patients were 23-73 years of age (average, 43 years). The ovarian and cervical tumors were synchronous in eight patients; in three, ovarian tumors were discovered 10 months, 2.5, and 3 years after the detection of a cervical neoplasm. In one patient, the cervical tumor was not discovered until autopsy 7 months after presentation. Four patients had abdominal swelling or distention, three had vaginal bleeding, three had an abnormal Papanicolaou smear, and two had masses discovered during pelvic examination. The ovarian tumors, six of which were bilateral, ranged from 5-17 cm (average, 9.5 cm) in maximal dimension in 11 patients; in the 12th patient, the involved ovary was not enlarged. The cervical tumors were grossly evident in 10 patients. They were usually deeply invasive, often with extracervical extension. Four were squamous cell carcinomas; two, small cell carcinomas; one, a mixed small cell carcinoma and adenocarcinoma; one, a mixed poorly differentiated carcinoid and adenocarcinoma; two, adenosquamous carcinomas; one, a transitional cell carcinoma; and one, an undifferentiated carcinoma. Various features, including bilaterality of the ovarian tumors, the finding that the histologic features of the ovarian tumors typically were unusual for a primary ovarian neoplasm, and the presence of extensive extracervical disease, led to the conclusion that the ovarian tumors were metastatic from the cervix. Although ovarian metastases of cervical carcinoma are uncommon, this series illustrates that, occasionally striking examples with clinical manifestations of ovarian involvement occur.
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PMID:Ovarian metastases from cervical carcinomas other than pure adenocarcinomas. A report of 12 cases. 838 Jul 53

A 46-year-old women was examined for severe constipation. Pelvic examination revealed a large pelvic mass extending to the level of the umbilicus. Computed tomography showed a large multicystic, septated mass in the pelvis and a small amount of fluid in the cul de sac. In addition, multiple ill-defined, mixed-attenuation hepatic lesions were identified. A malignant ovarian neoplasm with liver metastases was considered, so the pelvic mass was resected. Interestingly, histopathologic analysis revealed malignant struma ovarii of the follicular type. Biopsy of the liver lesions confirmed metastatic disease with similar histopathologic findings. All thyroid laboratory values were in the normal range. The patient then had a total thyroidectomy to optimize thyroid ablation therapy with I-131. This revealed a small follicular adenoma but no evidence of cancer. An I-131 whole-body scan was performed and showed uptake in multiple functioning liver metastases.
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PMID:Functioning liver metastases on an I-131 whole-body scan: a case of malignant struma ovarii. 1083 96

We report the clinicopathologic findings for 7 patients with completely staged ovarian micropapillary serous borderline tumors (MSBTs) to further clarify tumor behavior. None of the MSBTs had microinvasion in the ovarian neoplasm. The MSBT pattern constituted 25% to almost all of the neoplasm. Four were bilateral, and 6 involved the ovarian surface. Five patients had peritoneal implants; 2 were invasive, and 3 were noninvasive MSBTs. Distribution of stages among patients was as follows: IA, 1; IC, 1; IIC, 2; IIIB, 2; and IIIC, 1. Median follow-up was 8.5 years. Four patients were alive and well at the last follow-up visit, including 1 patient with stage IIIC (lymph node metastases) disease who had noninvasive implants (12 years after surgery). One patient who was free of disease died of complications of chemotherapy and abdominal surgery. Two patients died of intra-abdominal neoplastic growth (stages IIC and IIIB) 5 and 9 years after surgery, respectively; both had invasive implants. Without invasive peritoneal implants, MSBTs seem to behave as similar staged nonmicropapillary serous borderline tumors without invasive peritoneal implants. With invasive peritoneal implants, they seem to behave as low-grade carcinomas. Pathologists should recognize MSBT as a neoplasm that can have adverse prognostic features, including invasive peritoneal implants.
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PMID:Ovarian micropapillary serous borderline tumors. Clinicopathologic features and outcome of seven surgically staged patients. 1098 38

Ovarian cancer is among the most lethal cancers in women because of its high metastatic potential and lack of response to therapy. An experimental model to study this disease was developed using a transformed granulosa cell line expressing a mutant p53 and Ha-ras. When injected into the ovary of nude mice in the presence of laminin-1, tumors develop in the ovary and peritoneum and metastasize to various organs, leading to death within 21 days. In contrast, when cells were injected in the presence of gelatin, development of tumors was slower and no metastases were observed by day 21. Here we investigated the possible mechanism by which laminin-1 exerts its promotion of tumorigenesis and metastasis. Cells were co-injected with laminin-1 and active laminin peptides from the alpha1; (A13: RQVFQVAYIIIKA, A12: WVTVTLDL RQVFQ, AG73: LQVQLSIR, IKVAV) and beta1 (YIGSR) chains. Ovarian tumor growth and metastasis were increased in the presence of laminin-1 plus either AG73 peptide, IKVAV, or A13, and were significantly reduced in the presence of A12 or YIGSR. Expression of Bcl-2 and Mdm2 was higher by 3.5- and about 100-fold, respectively, in ovarian tumors grown in the presence of laminin compared to tumors grown in the presence of gelatin. Moreover, peptides A13 and AG73 further elevated Bcl-2 expression by 6- and 7-fold respectively, while IKVAV yielded expression similar to laminin-1. YIGSR and A12 reduced the expression of Bcl-2 by 7- and 3-fold, respectively, compared to treatment with laminin-1. A13 and AG73 increased Mdm2 expression by 1.8- and 1.3-fold, respectively, while IKVAV, A12, and YIGSR were without effect. Thus, laminin-1 exerts its proliferative effect on the development of ovarian tumors via upregulation of survival genes such as Bcl-2 and Mdm2. Peptides A13 and AG73 (which increased tumor growth and spread) enhance the expression of these genes and A12 and YIGSR (which decrease tumor growth and spread) attenuate their expression. IKVAV probably enhances tumor growth and metastasis by another mechanism.
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PMID:Role of laminin in ovarian cancer tumor growth and metastasis via regulation of Mdm2 and Bcl-2 expression. 1129 35

The detection of ovarian cancer remains a major challenge for gynecologists, as the majority of cases are symptomatically silent until regional metastases or ascites have occurred. This report examines a case of early-stage ovarian adenocarcinoma presenting with irritative voiding symptoms and urge incontinence, all of which resolved fully following surgery. We also report on the frequency of lower urinary tract symptoms leading to the detection of early-stage ovarian cancer, within a cohort of 52 consecutive patients surgically treated at our institution. Lower urinary tract symptoms may trigger the diagnosis of early ovarian cancer in up to 11% of surgically managed patients at our institution. To our knowledge there are no previous reports of early ovarian cancer causing transient irritative voiding symptoms or urge incontinence. This report highlights the importance of considering ovarian neoplasm as a relatively uncommon but critically important etiology accounting for these common female urologic complaints.
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PMID:Early-stage ovarian carcinoma presenting with irritative voiding symptoms and urge incontinence. 1171 3

Breast metastasis from a primary ovarian neoplasm is very rare. We report a case of breast metastasis along with involvement of the liver, spleen, and pelvis from ovarian carcinoma in a 54-year-old woman demonstrated by whole-body bone scanning. Ovarian metastatic deposits frequently show calcification, and a Tc-99m MDP bone scan could be useful in determining the extent of calcified soft tissue metastatic spread in these patients. A review of the literature of breast metastases form ovarian carcinoma is discussed.
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PMID:Bone scan demonstrating metastasis to the breast from an ovarian carcinoma and a review of the literature. 1516 86


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