title: Lung cancer diagnosis on ovary mass: a case report.
abstract: Metastatic neoplasms to the ovary often cause diagnostic problems, in particular those large ovarian masses mimicking primary tumors. Most of these tumors arise from digestive system or breast, while 37-year-old woman diagnosed as right adnexal complex mass, with a subpleural nodule in the apical part of the left lower lobe, at preoperative chest computed tomography scan. The patient underwent total abdominal hysterectomy with right salpingo-oophorectomy (ovarian mass 220 × 200 mm), total omentectomy, left ovarian biopsy, peritoneal random biopsies, and peritoneal washings for cytology. Pathologic and immunohistochemical examination of ovarian specimen suggested morphology and expression of metastatic lung adenocarcinoma with an intense positivity for Thyroid Transcriptional Factor-1 (TTF-1) and Cytokeratin 7 (CK7) staining. Fine needle biopsy of the lung nodule found epithelioid like malignant cells, confirming the diagnosis of an ovarian metastasis from a primary lung cancer.This report focused on the clinical and pathologic diagnostic challenge of distinguishing secondary from primary ovarian neoplasms. Issues on useful immunohistochemical stains are also discussed.
authors.affiliation: Department of Surgical Pathology, National Cancer Institute "G, Pascale", Naples, Italy. monicantile@libero.it.
authors.forename: Nunzia Simona
authors.initials: NS
authors.lastname: Losito
authors.forename: Cono
authors.initials: C
authors.lastname: Scaffa
authors.forename: Monica
authors.initials: M
authors.lastname: Cantile
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Raffaele
authors.initials: R
authors.lastname: Costanzo
authors.forename: Angela
authors.initials: A
authors.lastname: Manna
authors.forename: Renato
authors.initials: R
authors.lastname: Franco
authors.forename: Stefano
authors.initials: S
authors.lastname: Greggi