A Study of Rare Distant Metastatic Disease of Ovarian and Peritonealcarcinomatosis

Abstract

Introduction: Ovarian cancer predominantly spreads within the peritoneal cavity causing peritoneal carcinomatosis, which is associated with poor prognosis. Rare distant metastases beyond the abdomen, including sites such as the liver parenchyma, lungs, brain, bone, and distant lymph nodes, represent a distinct and aggressive disease subset with limited clinical data. Aims: To evaluate clinical profiles and patterns of rare distant metastases in ovarian and peritoneal cancer. Materials and Methods: This retrospective, observational cohort study was conducted over a period of one year in the Department of Gynaecology & Obstetrics, Murshidabad Medical College and Hospital, West Bengal 742101. The study included a total of 400 patients with histologically confirmed primary ovarian or peritoneal carcinoma. Result: Out of 400 ovarian cancer patients, rare distant and intra-abdominal metastases showed varied frequency and prognosis. CNS (12%) and bone (8%) metastases had poor survival (10 and 7.5 months, respectively). Eye and skin metastases (4% each) had slightly better outcomes (14 and 12 months). No cases involved supraclavicular or inguinal nodes, while mediastinal-cardiophrenic (4%) and breast node (8%) metastases showed better survival (18 and 16 months). Among intra-abdominal sites, the spleen was most common (20%), followed by GI tract (12%), bronchus/trachea (8%), heart (4%) and placenta/fetus (4%) with survival ranging from 7 to 17 months. Prognosis varied significantly by site. Conclusion: Rare distant metastatic disease in ovarian cancer represents a biologically aggressive pattern with poorer prognosis than peritoneal carcinomatosis. Improved diagnostic vigilance and individualized treatment strategies are crucial. Future studies should focus on molecular profiling to better understand the metastatic behavior and identify therapeutic targets.