Ovarian metastasis after radical nephrectomy for primary renal clear cell carcinoma : a diagnostic challenge

Renal clear cell carcinoma (RCC) can lead to metastases in unusual sites, but rarely in the ovary. Differentiation between primary ovarian tumors and ovarian metastases from RCC has different prognostic and therapeutic implications. As ovarian metastasis from RCC resembles a primary ovarian tumor, diagnosis often presents a histopathological challenge. Immunohistochemistry has proved very useful in distinguishing primary ovarian lesions from RCC metastases in the ovary, generally using CK7, CK20, vimentin, ER and CA125. There are 15 documented cases in the English literature of ovarian metastases developing from RCC confirmed by immunohistochemistry, often discovered during follow-up of the primary renal carcinoma. The search engine used for the literature review was PUBMED with “renal clear cell carcinoma”, “ovary”, and “ovarian metastasis” as key words. Here we present the 16th case of RCC metastasis in the ovary, first appearing as highly hemorrhagic tumors