Uteruslike masses of the ovary associated with breast cancer and raised serum CA 125.

Pai SA, Desai SB, Borges AM
The American journal of surgical pathology · 1998 · doi:10.1097/00000478-199803000-00008 · PMID:9500775
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Three cases of ovarian masses resembling the uterus, associated with breast cancer and elevated CA-125 levels, suggest an endomyometriosis etiology driven by metaplasia rather than congenital anomalies.

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This case series describes three patients aged 38 to 43 who presented with uteruslike masses of the ovary, a rare condition where the ovarian tissue grossly and microscopically resembles uterine structures. Two of these individuals also had concurrent breast carcinomas and elevated serum CA-125 levels, which initially raised clinical suspicion for ovarian malignancy. The authors conclude that the presence of residual ovarian stroma in patients with breast cancer suggests metaplasia rather than a congenital anomaly as the underlying cause, noting that elevated CA-125 is consistent with the endomyometriosis nature of the lesion. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

We describe three cases of a uteruslike mass of the ovary, a condition in which the ovary is replaced by a mass that grossly and microscopically resembles the uterus. The patients were 38, 43, and 39 years of age, and only the first was nulliparous. Two of them also had breast carcinomas. Two patients also had elevated CA 125 levels that gave rise to a clinical suspicion of ovarian malignancy. There were no anatomic abnormalities in any of the patients. The presence of residual ovarian stroma in two of the patients (both of whom had breast cancer) suggests that metaplasia rather than a congenital anomaly is the cause. Elevated CA 125 levels are consistent with the endomyometriosis nature of the lesion.
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Original Articles Uteruslike Masses of the Ovary Associated With Breast Cancer and Raised Serum CA 125 - Sanjay A. Pai - Sangeeta B. Desai - Anita M. Borges American Journal of Surgical Pathology 22(3):p 333-337, March 1998. We describe three cases of a uteruslike mass of the ovary, a condition in which the ovary is replaced by a mass that grossly and microscopically resembles the uterus. The patients were 38, 43, and 39 years of age, and only the first was nulliparous. Two of them also had breast carcinomas. Two patients also had elevated CA 125 levels that gave rise to a clinical suspicion of ovarian malignancy. There were no anatomic abnormalities in any of the patients. The presence of residual ovarian stroma in two of the patients (both of whom had breast cancer) suggests that metaplasia rather than a congenital anomaly is the cause. Elevated CA 125 levels are consistent with the endomyometriosis nature of the lesion. Copyright © Lippincott-Raven Publishers

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