Kidney Carcinoma Ovarian Metastasis: Review of the Literature

Abstract

Ovarian metastasis is common with secondary tumors representing up to 15% of ovarian neoplasms. The malignancies most commonly involving the ovaries are carcinomas of the stomach, colon, breast, endocervix, endometrium, and lymphoma. Secondary ovarian involvement by kidney carcinoma occurs very rarely and is usually associated with widespread dissemination.We conducted a review of kidney carcinoma with ovarian metastasis in the literature using the keywords clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma collecting duct carcinoma, and ovarian metastasis on Google Scholar and PubMed indices in April 2018, including a case diagnosed in our department. To date, 30 articles presenting 41 cases of kidney carcinoma with ovarian metastasis are reported in the literature. All reviewed cases were analyzed for diagnosis, surgical and systemic therapy, and outcome.Diagnosis may sometimes be challenging, requiring appropriate immunohistochemical markers in difficult cases. A combination of surgery and adjuvant therapy offers significant benefit in disease control or palliation of symptoms. Due to inconsistency in the reported data, further studies are needed to make safe conclusions regarding survival.

Bilateral ovarian metastasis of clear-cell renal cell carcinoma: A case report

“…The immunohistochemical distinction of primary versus secondary clear-cell carcinomas of the ovary could pose a diagnostic challenge. Two of the most useful biomarkers for distinguishing these two entities include CD-10 and monoclonal RCC antibody, which are both negative in primary clear-cell ovarian carcinoma, but both positive in metastatic clear-cell RCC in the ovary [6]. Our ovarian specimen stained positive for the RCC antibody, further supporting the metastatic RCC diagnosis.…”

“…Given that the left ovarian vein empties directly into the left renal vein and the right ovarian vein into the inferior vena cava, one may expect a preferred route of ovarian metastasis from the left kidney. However, a recent literature review of 41 cases by Koufopoulos et al [6] revealed nearly equal occurrence in the left (49%) versus right (51%) renal origins of ovarian metastasis. In the setting of bilateral ovarian masses and a renal mass, renal metastasis from a primary ovarian cancer can also be considered although this is considerably less common [14].…”

“…Patients with metastatic RCC traditionally receive radical nephrectomy with lymph node dissection, surgical resection of the metastatic disease, with or without adjuvant chemotherapy. In the reported cases of RCC metastasis to the ovary, 12 out of 41 patients (29%) of patients received chemotherapy sometimes in combination with adjuvant interferon-a immunotherapy or interleukin-2 (IL-2) cytokine therapy [6]. Current FDA-approved first-line immunotherapies [16] also include cabozantinib (tyrosine kinase inhibitor, TKI), nivolumab (anti-PD-1), ipilimumab (anti-CTLA-4), atezolizumab (anti-PDligand 1), and bevacizumab (anti-vascular endothelial growth factor, VEGF).…”

“…Although the lungs, bones, and liver are the most common metastatic sites of RCC, brain and adrenal metastasis are often encountered [5]. A review of the literature demonstrates that metastatic involvement of the ovaries is an exceptionally rare event, as evidenced by infrequent case reports with occasional case series published in the past few decades [6][7][8][9][10]. Most recently, Koufopoulos et al [6] published a thorough literature review with 41 cases of ovarian metastasis of RCC; only 11 of these cases involved bilateral ovaries.…”

CT and MR imaging findings of bilateral ovarian metastasis from renal cell carcinoma: a case report

“…Ovarian metastasis from RCC is very rare, and most of these cases are reported in a case report. According to a review of 41 cases, 1 most were composed of clear cell type RCC. In this report, ovarian metastases were observed on the ipsilateral side of the primary site in 13 cases, contralateral in 15, and bilateral in 11 cases.…”