Variations in radiological features between primary and secondary ovarian malignancies

Abstract

Objectives: To describe the patient characteristics, imaging features, biomarkers raising the possibility of secondary ovarian tumors. How imaging features of secondary ovarian tumors vary according to the origin of the primary tumor. Methods: Between January 2012 and September 2016, we conducted a retrospective study of 50 pathologically confirmed ovarian metastasis. We reviewed patient's medical records and retrieved their clinicopathological characteristics and reviewed their radiological images to evaluate discrepancies in the imaging features between ovarian metastasis and the primary tumor. Results: The majority of our patients were younger than 50y (72%), had bilateral ovarian metastasis (64%), elevated CA-125 (64%), lesion less than 9 cm (68%), and have mixed solid and cystic lesion (82%). 70% of lesions with solid component has a moderate pattern of enhancement. While, 90% of ovarian metastasis derived from cancer stomach, breast, lymphoma was solid; 81% of metastases arising from the primary tumor in the small intestine, colon, rectum or biliary tract was mixed (P < 0.0001). Also, Metastases from the primary tumor in the stomach, breast, and lymphoma were significantly smaller than those from colorectal or biliary tract cancers (P = 0.02). Conclusion: possibility of secondary ovarian tumors should be considered in cases with bilateral relatively small solid ovarian tumors in a woman with age <50 years old with normal or mild elevated CA 125 level. Imaging features may differ according to the primary tumor.