Two young women with alveolar rhabdomyosarcoma metastatic to the ovary are reported. In each case, the ovarian involvement was detected within a few weeks of the discovery of a soft tissue mass by the patient. Symptoms attributable to the ovarian tumor dominated the initial clinical picture in one case. In the other case, the soft tissue mass was not appreciated by the treating physicians until after the diagnosis of rhabdomyosarcoma had been established by examination of the ovarian tumor. The ovarian tumor was unilateral in one case and bilateral in the other. One primary site was the right foot and the other primary site was the left forearm. These cases illustrate that metastatic alveolar rhabdomyosarcoma rarely enters into the differential diagnosis of a small cell malignant tumor of the ovary. Both patients experienced progression of their disease and died, despite aggressive chemotherapy, within 1 year of presentation.
Cancer 64:899-904, 1989.
LTHOUGH there is extensive literature on the spread A of various carcinomas to the ovary,' little information exists concerning the similar spread of sarcomas.
In a consultation practice, we have encountered occasional sarcomas with prominent metastatic involvement of the ovary. Their identification poses no problem in most cases because of the clinical history and their distinctive morphologic features. We have encountered, however, two cases of alveolar rhabdomyosarcoma metastatic to the ovary that posed more diagnostic difficulty than usual. In one of the cases, the primary tumor was initially overlooked clinically. The differential diagnosis in both cases involved several other small cell neoplasms that may involve the ovary in young women.