Clinico-pathological studies on ovarian metastasis from gastric cancer

Thirty autopsied female patients with gastric cancer were investigated clinico-pathologically, regarding ovarian metastases. According to the histological pattern of the ovarian metastases, there were five types; no-metastasis in five, capsular type (cancer involvement confined to the capsule) in three, hilar type (carcinoma is evident in the hilus but not in the cortex or medulla) in four, multifocal type (multifocal growth of cancer in the cortex and/or medulla) in eight and diffuse type (diffuse proliferation of cancer) in ten. Although marked peritoneal dissemination was noted in 27, the capsule of the ovaries was usually intact. These results suggest that in the development of ovarian metastasis, cancer cells first reach the hilus, then spread into the medulla or cortex multifocally, and later grow diffusely. While cancer cells reach and cover the capsule of the ovary in many instances, they seldom break and invade it. All seven patients, except one unknown patient, with no-metastasis and with the capsular type were postmenopausal, while one hilar, two multifocal and five diffuse type women were premenopausal. This indicates an "affinity" of ovarian tissue for cancer cells, in younger patients.