Gastrointestinal Stromal Tumour metastatic to the ovary

Epidemiology

There have been very few reports of GIST metastatic to the ovaries. In one case the ovarian metastasis became apparent 27 years after the small intestinal primary. Small intestinal primaries are more prone to metastatic behaviour than are gastric primaries.

Clinical features

Patients may present with hyperoestrogenic symptoms due to secondary ovarian stromal luteinisation.

Immunohistochemistry

	CD117	5/51
	Vimentin	4/41
	h-caldesmon	4/4 (in one case, staining was weak)1
	desmin	0/51
	CD34	2/5 (plus one case in which CD34 was positive only within the small bowel component)1
	S-100	0/5 (staining was described as "weak" and "faint" each in one case respectively)1
	AE1/AE3	0/41
	SMA	1/11

Differential diagnosis

• Metastatic endometrial stromal sarcoma: positive for CD10 but negative for CD117 and CD34.

• Leiomyosarcoma, primary or metastatic from the uterus

• Leiomyomatosis peritonealis disseminata consists of multiple peritoneal or omental nodules without a dominant mass.

• Cellular fibroma

• Fibrosarcoma

• Sarcomatoid sex cord stromal tumour: positive for inhibin and calretinin

• If signet ring cells are present: metastatic signet ring cell tumour (Krukenberg tumour): positive for mucin and cytokeratins

• Metastatic melanoma

References

¹Irving JA, Lerwill MF,Young RH Gastrointestinal stromal tumors metastatic to the ovary: a report of five cases. Am J Surg Pathol 2005; 29:920-6

This page last revised 15.9.2005.

©SMUHT/PW Bishop