Metastatic ovarian or colonic cancer: a clinical challenge.
Clinical problems arise when histology is unable to differentiate between an ovarian carcinoma infiltrating into the rectosigmoid region and a colonic cancer with ovarian metastases. To evaluate the discriminative value of immunohistochemistry we studied four groups: (A) ovarian carcinoma (n = 21), (B) ovarian carcinoma with sigmoid stenosis (n = 18), (C) colonic carcinoma (n = 20) and (D) a group in which the differential diagnosis was a problem (n = 19). Paraffin sections stained with a panel of monoclonal antibodies revealed specific patterns: in group A and B a negative Parlam-4 and positive OC-125; in group C the opposite; in group D the 'colonic' pattern in 15 cases, and the 'ovarian' pattern in only 2. The clinical diagnosis in group D during follow-up was ovarian carcinoma in 7, colonic carcinoma in 8, double tumour in 1 and still unknown in 3. This was based on high levels of serum tumour markers such as carcinoembryonic antigen (n = 5) and CA-125 (n = 4), laparotomy (n = 4), autopsy (n = 1), barium enema and/or endoscopy (n = 5). The response to chemotherapy in group D was extremely poor.
Taal
B G
BG
Department of Gastroenterology, Netherlands Cancer Institute, Antoni van-Leeuwenhoek Huis, Amsterdam.
Hageman
P C
PC
Delemarre
J F
JF
Bonfrèr
J M
JM
den Hartog Jager
F C
FC
D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D012809:Colon, Sigmoid / Q000473:pathology; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary*
D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen