Synchronous primary cancers of the endometrium and ovary versus endometrial cancer with ovarian metastasis: a single institution retrospective observational study

OBJECTIVE: To compare the ultrasound characteristics of patients with synchronous primary cancers of the endometrium and ovary versus those of patients with endometrial cancer with ovarian metastases. METHODS: This is a single retrospective observational study. We identified patients with a histological diagnosis of endometrial cancer and an ovarian malignant mass, who had undergone preoperative ultrasound examination, in order to compare the ultrasound features of ovarian malignant masses between patients with synchronous primary cancers of the endometrium and ovary (synchronous group) and patients with endometrial cancer with ovarian metastases (metastatic group). Moreover, ultrasound features of endometrial cancers between the two group were evaluated. T-Student, Mann-Whitney, χ2, or Fisher's exact tests were used for comparison between the two histological groups, as appropriate. RESULTS: We identified 51 patients in the synchronous group and 80 patients in the metastatic group. At ultrasound examination, ovarian masses of the synchronous group were more often multilocular-solid and less often bilateral than ovarian masses of the metastatic group. Regarding the ultrasound features of endometrium, the median largest diameter of the endometrial lesion was 29 mm in the synchronous group and it was 51.5 mm in the metastatic group (p<0.0001). Endometrial lesions of the synchronous group presented more often no myometrial infiltration than those of the metastatic group. At color Doppler examination, endometrial lesions of the synchronous group presented less often "multiple vessel" pattern than those of the metastatic group. CONCLUSIONS: Synchronous primary cancers of the endometrium and ovary have significantly different sonomorphologic patterns compared with endometrial cancer with ovarian metastases. Ovarian masses in synchronous primary cancers of the endometrium and ovary appeared as unilateral multilocular-solid or solid masses, whereas ovarian masses in endometrial cancers with ovarian metastases were mostly bilateral solid masses. The sonomorphology of these two groups may facilitate their preoperatively identification helping the surgeon to determine the optimum management for the patient. This article is protected by copyright. All rights reserved.