[Ovarian metastases of digestive cancers. Diagnostic and therapeutic management]

Although ovarian metastasis of digestive cancers were well known since more 80 years, the management of ovaries is still discussed. The authors reviewed 112 cases of digestive tumors in female patients operated between 1973 and 1987, excluding the peritoneal carcinomatosis, and report 7 cases of ovarian metastasis. The primary carcinoma was gastric (2 cases) colonic (2 cases) appendicular (1 case) small bowel (1 case) and biliary tract (1 case). Because the severe prognosis and the frequent revealing and isolated feature of the ovarian metastases the authors review the literature in order to propose recommendations regarding the diagnosis and treatment according to the localisation, the grading of the primary tumor particularly in non menopausal patients. When the primary tumor is a mucinous signet-ring carcinoma with spread to the serosa and a gross abnormality of an ovary is discovered the oophorectomy should be performed. In every cases an immediate histological examination is absolutely necessary. Clinical and sonographic findings are included in the operative staging and the follow up of patients operated for a digestive adenocarcinoma. Especially if the ovarian tumor is bilateral a complete digestive check-up including appendix and biliary tract is necessary.