Horn L-C, Einenkel J, Handzel R, Höhn A K
Abteilung Mamma-, Gynäko- & Perinatalpathologie, Institut für Pathologie, Department für Diagnostik, Universitätsklinikum Leipzig AöR, Liebigstr. 24, 04103, Leipzig, Deutschland,
Pathologe. 2014 Jul;35(4):336-47. doi: 10.1007/s00292-014-1907-1.
The distinction between primary and secondary (metastatic) ovarian tumors is essential for the selection of appropriate surgical interventions, chemotherapeutic treatment and prognostic evaluation for the patient. Metastatic tumors of the ovary range between 5 % and 30 %. The majority of ovarian metastases in Europe and North America derive from colorectal (25-50 %) and breast cancers (8-25 %). A major issue is the differential diagnosis of mucinous tumors. Major features favoring metastasis include bilaterality, size < 10 cm, ovarian surface involvement, extensive intra-abdominal spread, and infiltrative growth within the ovary involving the corpus albicans and corpora lutea. An algorithm using bilaterality and tumor size (cut-off 10 cm) allows correct categorization in approximately 85 % of the cases. Although immunohistochemistry (especially CK7 and CK20 in mucinous tumors) using a panel of antibodies plays a valuable role and is paramount in the diagnosis, the results must be interpreted with caution and within the relevant clinical and histopathological context. It is necessary to note that the correct diagnosis of ovarian metastases always needs interdisciplinary and multidisciplinary approaches.
原发性和继发性（转移性）卵巢肿瘤的区分对于为患者选择合适的手术干预、化疗治疗及预后评估至关重要。卵巢转移性肿瘤占比在5%至30%之间。在欧洲和北美，大多数卵巢转移瘤源自结直肠癌（25%-50%）和乳腺癌（8%-25%）。一个主要问题是黏液性肿瘤的鉴别诊断。支持转移的主要特征包括双侧性、大小<10 cm、卵巢表面受累、广泛的腹腔内播散以及卵巢内累及白体和黄体的浸润性生长。使用双侧性和肿瘤大小（临界值10 cm）的算法可在约85%的病例中进行正确分类。尽管使用一组抗体的免疫组织化学（尤其是黏液性肿瘤中的CK7和CK20）发挥着重要作用且在诊断中至关重要，但结果必须在相关临床和组织病理学背景下谨慎解读。需要注意的是，卵巢转移瘤的正确诊断始终需要跨学科和多学科方法。
