Metastatic ovarian squamous cell carcinoma

Samaila MOA, Adesiyun AG, Oluwole OP
Correspondence: Dr Modupeola O Samaila, mamak97@yahoo.com

ABSTRACT
Ovarian squamous cell carcinoma is usually associated with germ cell tumours (dermoid cyst) or endometriosis in primary cancer. While tumour metastasis to the ovary is common and often bilateral in over 50 percent of cases, metastatic cervical squamous cell carcinoma to the ovary is infrequent compared to adenocarcinoma from other extraovarian primaries and the cervix. We report two cases of unilateral metastatic ovarian squamous cell carcinoma from the uterine cervix in two women aged 38 years and 48 years, respectively. They presented with abdominopelvic masses, clinically thought to be tuberculosis and primary ovarian tumour, respectively. Both had laparotomy which revealed multinodular ovarian masses with extensive extra-ovarian involvement of the corpus and uterine cervix by tumour and omental seedlings. Tissue microscopy showed total replacement of ovarian stroma by tumour with necrotic foci and containing infiltrating nests and cords of malignant squamous cells with prominent intercellular bridges. No evidence of teratoma or endometriosis was seen in the histology sections. They were both diagnosed with metastatic ovarian squamous cell carcinoma with advanced stage disease primary in the uterine cervix. Ovarian metastatic squamous cell carcinoma from the uterine cervix may occur with advanced stage cervical carcinoma. Unilateral multinodular ovarian mass with extensive extra-ovarian tumour involvement should raise suspicion of metastasis rather than of primary tumour. Early and prompt diagnosis is desirable in the management of these patients.

Keywords: ovarian metastasis, squamous cell carcinoma, uterine cervix, uterus
Singapore Med J 2008; 49(5): e139-e141