Differential diagnosis of primary and metastatic ovarian carcinomas

Ovarian tumors constitute 3.4 % of the structure of oncological diseases in women worldwide. However, the ovaries are also a common target for metastasis of carcinoma from other organs. Conducting differential diagnosis between primary carcinoma and metastasis is often challenging. The aim of thi...

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Main Authors: L. M. Zakhartseva, O. P. Manzhura, I. Yu. Vashchenko, Ye. V. Maistrenko, O. M. Kravchuk, K. M. Shatrova, O. H. Rudnytska
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2023-12-01
Series:Patologìâ
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Online Access:http://pat.zsmu.edu.ua/article/view/291530/287490
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author L. M. Zakhartseva
O. P. Manzhura
I. Yu. Vashchenko
Ye. V. Maistrenko
O. M. Kravchuk
K. M. Shatrova
O. H. Rudnytska
author_facet L. M. Zakhartseva
O. P. Manzhura
I. Yu. Vashchenko
Ye. V. Maistrenko
O. M. Kravchuk
K. M. Shatrova
O. H. Rudnytska
author_sort L. M. Zakhartseva
collection DOAJ
description Ovarian tumors constitute 3.4 % of the structure of oncological diseases in women worldwide. However, the ovaries are also a common target for metastasis of carcinoma from other organs. Conducting differential diagnosis between primary carcinoma and metastasis is often challenging. The aim of this study is to highlight the issues of morphological and immunohistochemical differential diagnosis of primary ovarian carcinomas and metastases from carcinomas of various organs to the ovaries. Materials and methods. Data analysis of clinical and pathohistological studies of 381 patients. Paraffin sections for pathohistological studies were stained with hematoxylin and eosin using standard methodology. Immunohistochemical studies were conducted in 161 cases using a panel of antibodies: cytokeratins, estrogen receptors, progesterone receptors, CA125, TTF1, Vimentin, CDX2, Villin, Chromogranin A, Synaptophysin, CD56, GATA, p53, Inhibin A, FOXL-2, PAX-8, Ki-67. The specimens were examined and analyzed using the Axioskop 40 microscope (Zeiss) with the AxioCam MRc camera (Zeiss). Results. The article discusses key issues of differential diagnosis of primary and metastatic ovarian carcinomas based on a large clinical and operational material. The application of an adequate panel of immunohistochemical antibodies for verification is considered. The results of the frequency of occurrence of different histological variants of ovarian carcinomas and metastases to the ovaries from carcinomas of other organs are provided based on our own research from 2019 to 2023. The main morphological and immunohistochemical indicators for practical use in the work of a pathologist in the verification of ovarian tumors are presented. An example of forming an antibody panel, taking into account clinical and morphological indicators in a specific clinical case from our own practice, is given. Conclusions. Metastases of carcinomas from other organs to the ovaries constitute half of all cases requiring immunohistochemical investigation based on morphological structure. The most common are metastases from breast and colorectal cancers. However, the diagnosis of metastatic intestinal carcinoma is particularly challenging, as there is usually no clear clinical picture. In the differential diagnosis of primary and metastatic ovarian tumors, a comprehensive approach to analyzing the clinical presentation, microscopic structure of the tumor, and the surrounding tissue plays a significant role. Additionally, the formation of an antibody panel, taking into account these data, is crucial. The article provides a list of antibodies that have demonstrated greater effectiveness in our work.
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spelling doaj-art-cda9fd72ca014e2c90f3e431429419ec2025-08-20T03:19:38ZengZaporizhzhia State Medical and Pharmaceutical UniversityPatologìâ2306-80272310-12372023-12-0120328128810.14739/2310-1237.2023.3.291530Differential diagnosis of primary and metastatic ovarian carcinomasL. M. Zakhartseva0https://orcid.org/0000-0001-6838-9970O. P. Manzhura1https://orcid.org/0000-0003-1070-8515I. Yu. Vashchenko2https://orcid.org/0009-0002-2491-8679Ye. V. Maistrenko3https://orcid.org/0009-0000-7037-7637O. M. Kravchuk4https://orcid.org/0009-0007-2093-3974K. M. Shatrova5https://orcid.org/0000-0003-2916-5098O. H. Rudnytska6https://orcid.org/0000-0002-4203-5231Bogomolets National Medical University, Kyiv, UkraineShupyk National Healthcare University of Ukraine, KyivKyiv City Clinical Oncology Center, UkraineKyiv City Clinical Oncology Center, UkraineKyiv City Clinical Oncology Center, UkraineShupyk National Healthcare University of Ukraine, KyivBogomolets National Medical University, Kyiv, UkraineOvarian tumors constitute 3.4 % of the structure of oncological diseases in women worldwide. However, the ovaries are also a common target for metastasis of carcinoma from other organs. Conducting differential diagnosis between primary carcinoma and metastasis is often challenging. The aim of this study is to highlight the issues of morphological and immunohistochemical differential diagnosis of primary ovarian carcinomas and metastases from carcinomas of various organs to the ovaries. Materials and methods. Data analysis of clinical and pathohistological studies of 381 patients. Paraffin sections for pathohistological studies were stained with hematoxylin and eosin using standard methodology. Immunohistochemical studies were conducted in 161 cases using a panel of antibodies: cytokeratins, estrogen receptors, progesterone receptors, CA125, TTF1, Vimentin, CDX2, Villin, Chromogranin A, Synaptophysin, CD56, GATA, p53, Inhibin A, FOXL-2, PAX-8, Ki-67. The specimens were examined and analyzed using the Axioskop 40 microscope (Zeiss) with the AxioCam MRc camera (Zeiss). Results. The article discusses key issues of differential diagnosis of primary and metastatic ovarian carcinomas based on a large clinical and operational material. The application of an adequate panel of immunohistochemical antibodies for verification is considered. The results of the frequency of occurrence of different histological variants of ovarian carcinomas and metastases to the ovaries from carcinomas of other organs are provided based on our own research from 2019 to 2023. The main morphological and immunohistochemical indicators for practical use in the work of a pathologist in the verification of ovarian tumors are presented. An example of forming an antibody panel, taking into account clinical and morphological indicators in a specific clinical case from our own practice, is given. Conclusions. Metastases of carcinomas from other organs to the ovaries constitute half of all cases requiring immunohistochemical investigation based on morphological structure. The most common are metastases from breast and colorectal cancers. However, the diagnosis of metastatic intestinal carcinoma is particularly challenging, as there is usually no clear clinical picture. In the differential diagnosis of primary and metastatic ovarian tumors, a comprehensive approach to analyzing the clinical presentation, microscopic structure of the tumor, and the surrounding tissue plays a significant role. Additionally, the formation of an antibody panel, taking into account these data, is crucial. The article provides a list of antibodies that have demonstrated greater effectiveness in our work.http://pat.zsmu.edu.ua/article/view/291530/287490ovarian neoplasmscarcinomaneoplasm metastasisdifferential diagnosis
spellingShingle L. M. Zakhartseva
O. P. Manzhura
I. Yu. Vashchenko
Ye. V. Maistrenko
O. M. Kravchuk
K. M. Shatrova
O. H. Rudnytska
Differential diagnosis of primary and metastatic ovarian carcinomas
Patologìâ
ovarian neoplasms
carcinoma
neoplasm metastasis
differential diagnosis
title Differential diagnosis of primary and metastatic ovarian carcinomas
title_full Differential diagnosis of primary and metastatic ovarian carcinomas
title_fullStr Differential diagnosis of primary and metastatic ovarian carcinomas
title_full_unstemmed Differential diagnosis of primary and metastatic ovarian carcinomas
title_short Differential diagnosis of primary and metastatic ovarian carcinomas
title_sort differential diagnosis of primary and metastatic ovarian carcinomas
topic ovarian neoplasms
carcinoma
neoplasm metastasis
differential diagnosis
url http://pat.zsmu.edu.ua/article/view/291530/287490
work_keys_str_mv AT lmzakhartseva differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT opmanzhura differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT iyuvashchenko differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT yevmaistrenko differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT omkravchuk differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT kmshatrova differentialdiagnosisofprimaryandmetastaticovariancarcinomas
AT ohrudnytska differentialdiagnosisofprimaryandmetastaticovariancarcinomas