title: Ovarian metastasis originating from bronchioloalveolar carcinoma: a rare presentation of lung cancer.
abstract: Ovarian metastasis originating from bronchioloalveolar carcinoma (BAC) has not been reported previously. We report a 63-year-old Chinese woman who was diagnosed as BAC with pleural metastasis in 1997. Four years later, she complained of vaginal bleeding, and a pelvic mass was discovered by an abdominal computerized tomography scan. Tumor debulking and total hysterectomy with bilateral salpingo-oopherectomy were performed. Pathology disclosed well-differentiated adenocarcinoma, with abundant clear cytoplasm, in the ovaries. Furthermore, immunohistochemical staining revealed that the tumor cells from the ovary and pleura were reactive to thyroid transcription factor 1 (TTF-1) and cytokeratin-7 (CK-7) but were negative for cytokeratin-20 (CK-20). The results of immunohistochemical staining, clinical course, and pathological features were compatible with the diagnosis of BAC with ovarian metastasis. In conclusion, to investigate the primary site of a metastatic ovarian cancer, clinicians should not forget the lungs since the incidence of lung cancer in females is increasing. Moreover, a monoclonal antibody panel for TTF-1, CK-7, and CK-20 may facilitate discrimination between primary and metastasized ovarian adenocarcinomas and/or identifying tumors of pulmonary origin.
authors.affiliation: Division of Hemato-oncology, Department of Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Kun-Yun
authors.initials: KY
authors.lastname: Yeh
authors.forename: John W-C
authors.initials: JW
authors.lastname: Chang
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
authors.forename: Ting-Chang
authors.initials: TC
authors.lastname: Chang
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007381:Intermediate Filament Proteins / Q000032:analysis; D053554:Keratin-20; D053552:Keratin-7; D007633:Keratins / Q000032:analysis; D008175:Lung Neoplasms / Q000473:pathology*; D008875:Middle Aged; D009687:Nuclear Proteins; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000601:surgery; D010052:Ovariectomy; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors
chemical_list: D014408:Biomarkers, Tumor; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; C000614412:NKX2-1 protein, human; D009687:Nuclear Proteins; D000074482:Thyroid Nuclear Factor 1; D014157:Transcription Factors; D007633:Keratins