Castadot P, Magné N, Berghmans T, Drowart A, Baeyens L, Smets D, Van Houtte P
Service de radiothérapie, institut Jules-Bordet, 121, boulevard de Waterloo, 1000 Bruxelles, Belgique.
Cancer Radiother. 2005 May;9(3):183-6. doi: 10.1016/j.canrad.2005.03.001. Epub 2005 Apr 9.
Ovarian metastasis as first dissemination site of a lung adenocarcinoma has not been described in the literature. We report the case of a 61-year-old woman who had a pneumectomy for a centrally located lung adenocarcinoma, which was discovered on a routine chest X-Ray. During the follow-up, a Positron Emission Tomography (PET)-Scan showed a hypercaptation in the pelvic region. Abdominal CT-scan confirmed the presence of a mass which was compatible with a primary ovarian tumor. The patient underwent a hysterectomy and bilateral salpingo-oophorectomy. Pathology reported an adenocarcinoma. Immunohistochemical staining revealed cells expression for Thyroid Transcription Factor 1 (TTF-1), cytokeratin 7 (CK-7) and focally cytokeratin 20 (CK-20). Clinical course, pathological and immunohistochemical data concluded to the diagnosis of ovarian metastasis of the lung adenocarcinoma. In conclusion, in the differential diagnosis of an ovarian metastasis, clinicians should not forget the lung as primary site since epidemiologic data of lung cancer in women show progressive incidence.
卵巢转移作为肺腺癌的首个播散部位在文献中尚未见报道。我们报告一例61岁女性病例，该患者因常规胸部X线检查发现中央型肺腺癌而行肺切除术。随访期间，正电子发射断层扫描（PET）显示盆腔区域摄取增加。腹部CT扫描证实存在一个与原发性卵巢肿瘤相符的肿块。患者接受了子宫切除术和双侧输卵管卵巢切除术。病理报告为腺癌。免疫组化染色显示细胞表达甲状腺转录因子1（TTF-1）、细胞角蛋白7（CK-7），并局灶性表达细胞角蛋白20（CK-20）。临床病程、病理及免疫组化数据最终诊断为肺腺癌卵巢转移。总之，在卵巢转移瘤的鉴别诊断中，临床医生不应忽视肺部作为原发部位，因为女性肺癌的流行病学数据显示其发病率呈上升趋势。
