Ovarian serous carcinoma presenting with various histological morphology metastatic to the stomach : a case series
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Introduction: Ovarian serous carcinoma accounts for approximately 3% of all female malignancies with a high death-to-incidence ratio. A 15-20% survival rate makes understanding the histological patterns important for improving diagnostic timing in patients with ovarian serous carcinoma. Methods: This three-person case series, diagnosed between August 2011 to August 2013, includes analysis of ovarian serous carcinoma variant type, time from diagnosis of primary ovarian serous carcinoma to detection of gastric metastasis, histological grade, and presence of lymphovascular invasion. Results: Three patients with primary ovarian serous carcinoma with metastasis to stomach were observed. All patients were Caucasian. The mean age and time of diagnosis of metastatic gastric serous carcinoma was 68.6 years and 3 months, respectively. All patients underwent salpingo-oophorectomy following diagnosis of the primary tumor. Two patients were diagnosed with metastasis to stomach at time of initial diagnosis of the primary ovarian serous carcinoma. Remarkably, everyone had different histological types of ovarian serous carcinoma: papillary with clear cell features, clear cell serous, and high-grade serous, as shown in the figure. The two cases that presented with metastatic disease at initial diagnosis had a histological grade of poorly differentiated G3 with lymphovascular invasion present. Conclusion: Gastric metastasis in patients with serous carcinoma appears to present with varying histological morphology and can present at initial time of diagnosis of the primary. Most patients show concomitant tumor spread to other organs with poor outcomes. The varying histological morphology and poor prognosis is imperative when pathologists have a high clinical suspicion for metastatic serous carcinoma.
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