Metastatic Tumors of the Ovary

The most common site in the female genital tract for involvement by metastatic disease is the ovaries, which are rich vascular organs that receive metastases from numerous tissues. This chapter emphasizes on metastatic tumors of the ovaries. Estimates of the frequency with which tumors metastasize to the ovaries vary with the study design and nationality of the patient. The organs responsible for metastasis to the ovaries include: breast, large intestine, endometrium, and stomach. Tumors spread to the ovaries by different modes, which include direct extension, transtubal migration, and blood and lymphatic vascular invasion. Ovarian metastases range in size from microscopic to large and bulky tumors. Majority of metastases are bilateral. Common features of metastatic tumors include a grossly multinodular distribution in the ovarian parenchyma, and focal surface deposits. These gross and microscopic features of metastases are significantly helpful in certain histologies, where primary ovarian and metastatic tumors resemble each other.