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Gastrointestinal system-derived secondary gynecologic tumors: 10 years experience at a single center

Neslihan Bayramoglu Tepe, Zehra Bozdag, Huseyin Caglayan Ozcan, Ozcan Balat.

Aim: To perform a retrospective review of gynecologic malignancies originating from gastrointestinal system.
Material and Methods: The study included 35 patients who underwent surgery at Gaziantep University, Faculty of Medicine, Department of Gynecology and Obstetrics from January 2007 to December 2017 and they were diagnosed with secondary gynecological malignancies originating from the gastrointestinal system (GİS) in their pathological examination. The patients’ age, primary tumor, and metastatic tumor localization and size were recorded. The malignancies were classified based on origin, as those arising from the colon, appendix, pancreas, stomach, peritoneum, and those of an unknown origin.
Results: The mean age of the patients was 50.8 years (min: 24, max: 98) and the mean tumor diameter was 9.8 cm (min: 2 cm, max: 23 cm). Malignancies originating from the colon were most common secondary gynecologic malignancies. The primary tumor was localized at the colon in 21 patients (60%), stomach in eight (22.8%), and in the pancreas in one patient, appendix in one patient and peritoneum in one patient (2.8%). The origin of the primary tumor could not be determined in three patients (8.5%) as follow-up was not performed in our hospital for these patients. Of the malignancies originating from the colon (n=21), 16 (76.1%) metastasized to the ovaries, four (19%) to the vagina, and one (4.7%) to the cervix, while all tumors originating from the stomach, peritoneum, pancreas, appendix and those derived from the GIS without specific origin metastasized to the ovaries. Of the ovarian metastases, 26 (86.6%) were bilateral while four (13.3%) were unilateral. In metastatic tumors, pathological diagnoses included adenocarcinoma, signet ring cell carcinoma and mucinous carcinoma.
Conclusion: Female genital system is among the substantial targets of metastasis of GIS-derived tumors. Metastatic tumors have a more aggressive behavior. Metastatic tumors must be distinguished from primary tumors as treatment modalities differ in these tumors. For these reasons, a multidisciplinary approach should be employed in the diagnosis, management and follow-up of cases, and the genital system should be screened carefully during both preoperative assessment and postoperative follow-up in patients with primary GIS malignancies.

Key words: Metastatic Tumor; Gynecologic Tumor; Gastrointestinal System.

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