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open access
Case report
Published: 10 May 2013
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 x 200mm), 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.
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