Adenocarcinoma of the Lung with Ovarian Metastasis: A Case Report

Abstract

Ovarian adenocarcinoma can be either a primary ovarian neoplasm or metastasis from another primary site. Approximately 6% of ovarian cancers are metastatic, usually from the stomach, breast, pancreas, kidney, or colon. Reports of ovarian metastasis from lung cancer are relatively uncommon, even in autopsy series. Only approximately 5% of females with lung cancer have ovarian metastasis at autopsy. We report a 23-year-old woman who was diagnosed with adenocarcinoma of the lung, left upper lobe, with multiple brain metastasis, in December, 2001. She received cranial irradiation for brain metastasis and systemic chemotherapy, beginning in January, 2002. About 1 year later, she complained of lower abdominal tenderness, and a huge pelvic mass, about 20 centimeters in diameter, was disclosed by abdominal CT scan. Left salpingo-oophorectomy and pelvic lymph node dissection were performed in January, 2003. Pathology showed that the tumor cells were in a tubulopapillary pattern; their cytoplasm was clear and the nuclei were pleomorphic. Immunohistochemical staining with thyroid transcription factor-1 (TTF-1) showed nuclear staining in the tumorcells, compatible with lung cancer metastasis to the ovary. Even though ovarian metastasis is a rare presentation of lung cancer, the possibility should always be kept in mind when an ovarian tumor is found after lung cancer has been diagnosed.