Pancreatic cancer with ovarian metastasis: cases report and literature review

Abstract

Background: Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. Patients with ovarian metastases are first diagnosed with ovarian cancer and may miss the opportunity to receive surgical operation. We report 7 rare cases of ovarian metastases secondary to pancreatic adenocarcinoma and review the literature to analyze clinical characteristics, diagnostic methods, and potential therapeutic strategies for the rare malignancy.Cases Summary: We retrospectively analyzed the clinical data of 7 female patients with ovarian metastases of primary pancreatic cancer who were admitted to our hospital from January 01, 1985, to April 1, 2020. These 7 patients were diagnosed with ovarian metastasis at an average age of 52.28 (38-69) years. The reason for the patient's visit was generally a mass in the lower abdomen and/or abdominal pain. Six of them had significantly higher serum Carbohydrate antigen19-9 (CA19-9) levels, 6 patients had pancreatic tumors located in the body or tail, and 1 patient had one in the head of the pancreas. All patients underwent excision of ovarian tumors and resection or biopsy of pancreatic tumors. Five patients had pancreatic ductal adenocarcinoma (PDAC), and 2 had pancreatic cystadenocarcinoma (PCC), all of which were revealed by the pathological results. Ovarian tumors were assessed by pathology and were consistent with pancreatic metastasis. Currently, all 7 patients have died (follow-up to January 2, 2021). The median survival time for all patients was 13.7 months (2.9-27 months).Conclusions: For this rare tumor, elevated serum CA19-9 may indicate that the primary lesion is in the pancreas. Enhanced pancreatic Computed Tomography (CT) can facilitate diagnostic localization. In addition, if the pancreatic tumor cannot be removed, the ovarian tumor should still be resected to reduce the tumor load and improve the quality of life.

Mucin-Producing Lobular Breast Carcinoma Metastasis to an Ovarian Fibroma: Histopathological and Immunohistochemical Analysis of a Rare Case and Literature Review

“…Zhang JJ et al reported 6 breast tumors metastatic in an ovary from 177 tumors identified, but the histological type was not specified, and the CA-125 level was higher than 35 U/L in 65% of the cases included in their study [7]. In the rest of the analyzed studies, isolated cases of ovarian metastases of breast lobular carcinoma or tumors with primary localization in other organs were reported [2][3][4]6,[8][9][10][11]. The types of primary tumors metastatic to the ovary, their incidence, CA-125 levels, and the number of cases identified in the literature database are summarized in Table 2.…”

“…Ovarian metastases from breast cancer account for 3-30% of all ovarian ovarian neoplasms [1][2][3][4][5][6][7][8][9][10][11]. We identified both lobular and invasive ductal breast carcinoma studies with metastasis to the ovary, but the cases presented in the current literature data were We studied the biphasic tumor areas immunohistochemically and observed that the round cells were positive for AE-1/AE-3 cytokeratin, mammaglobin, and GCDFP-15, and the fusiform tumor cells stained for inhibin and calretinin (Figures 4 and 5).…”

“…Ovarian metastases from breast cancer account for 3-30% of all ovarian ovarian neoplasms [1][2][3][4][5][6][7][8][9][10][11]. We identified both lobular and invasive ductal breast carcinoma studies with metastasis to the ovary, but the cases presented in the current literature data were few.…”

“…The loss of the adhesion molecule E-cadherin, a hallmark of ILC, is implicated in the dissemination of tumor cells to distant sites and the occurrence of bilateralism. Metastases from breast ILCs have been documented in the bones, lungs, pleura, soft tissue, and liver [1][2][3][4][5][6][7][8][9][10][11][20][21][22][23][24][25][26][27][28][29].…”

“…Approximately 3-30% of ovarian tumors are metastases and originate mainly from the gastrointestinal tract [1]. Metastases from tumors of the breast, pancreas, endometrium, bladder, lungs, and kidney are also reported in a small number of cases [1][2][3][4][5][6][7][8][9][10][11]. Most ovarian metastases are from extragenital organs, with 6.7% being breast carcinomas [4].…”