Part 2 book “Gynecologic oncology clinical practice and surgical atlas” has contents: Perioperative and critical care, targeted therapy and immunotherapy, integrative oncology, quality of life, and supportive care, surgical instrumentation and sutures, uterine procedures, cervical procedures, and other contents. | Metastases to the Gynecologic Tract S. Diane Yamada and Nita K. Lee Metastases to the genital tract may occur as a result of recognizable widely disseminated disease from another site or as an isolated lesion. In the latter case, it may be difficult to distinguish between a primary tumor of the gynecologic tract or metastases to the gynecologic tract from a nongynecologic site. Because treatment planning and appropriateness of surgery may be dictated by the primary site of the tumor, it is important to make the distinction between primary and metastatic disease. This chapter focuses on common sites of metastases to the gynecologic tract, characteristic clinical presentations, and radiologic and pathologic considerations that may be clinically helpful in treatment planning. EPIDEMIOLOGY Key Points 1. Metastatic disease to the gynecologic organs most commonly arises from colorectal, breast, gastric, and appendiceal primary malignancies. 2. Within the reproductive tract, the ovaries and vagina are the organs most commonly affected by metastatic disease. 3. Malignant masses or lesions in the gynecologic organs should be considered as potential sites of metastases if an established primary malignancy is of advanced stage or demonstrates poor prognostic factors. Metastatic disease to the genital tract from nongenital tract malignancies is relatively uncommon but is influenced by geographic differences in cancer incidence. For instance, in Asian countries where gastric cancer is more common, metastatic disease to the genital tract is more prevalent. In Japan, 18% to 29% of tumors found in the reproductive organs may be non-gynecologic in origin; in Thailand, where cholangiocarcinoma is quite prevalent, 7% of all metastases to the genital tract may arise from the gallbladder or extrahepatic biliary A single-institution review from the United States of 445,000 accessioned cases identified 325 metastatic tumors to the genital tract over a 32year time period; 149
