Abstract
A 39-year-old woman underwent nephrectomy and ureterectomy for a transitional cell carcinoma involving the right renal pelvis and upper ureter. Four years later, the patient complained of vaginal spotting and abdominal pain. Bilateral adnexal masses were palpable on pelvic examination and a hysterectomy with bilateral salpingo oophorectomy was performed. The ovaries were both replaced by multicystic neo plasms measuring 10 and 12 cm in maximum dimension. Microscopic examination showed cysts lined by transitional cells, and nests of transitional cells permeated the intervening stroma. Prominent lymphatic and vascular invasion was also present. Tumor also filled the lumens of both fallopian tubes. Although only limited superficial invasion was demonstrated in the nephrectomy specimen, the features of the case strongly suggest that the ovarian tumors represent metastases from the transitional cell carcinoma of the renal pelvis. This represents only the third well documented case of clinically significant ovarian spread of this tumor. Problems that may be encountered in distinguishing between metastasis and an independent primary transitional cell ovarian tumor, (proliferative or malignant Brenner tumor, transitional cell carcinoma) are discussed.
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