Metastasis of Ovarian Cancer to the Lungs
Yes, ovarian cancer can metastasize to the lungs, which is one of the common sites of distant metastasis in advanced disease. Lung metastasis represents a significant progression of ovarian cancer and impacts both prognosis and treatment planning.
Patterns of Ovarian Cancer Metastasis
Ovarian cancer has a distinct pattern of spread that differs from many other malignancies:
- Primary spread occurs within the peritoneal cavity through direct extension and peritoneal fluid circulation 1
- Distant metastases (stage IV disease) develop in approximately one-third of ovarian cancer patients 2
- Common sites of distant metastasis include:
- Liver (most common)
- Pleura
- Lungs
- Central nervous system
- Skin
- Extra-abdominal lymph nodes 2
Lung Metastasis in Ovarian Cancer
Lung involvement occurs in several patterns:
- Parenchymal metastases (nodules within lung tissue)
- Pleural effusions (more common than parenchymal disease)
- Lymphangitic spread
- Endobronchial metastases (rare but documented) 3
According to a comprehensive study on distant metastases in ovarian cancer, lung metastases were found in 8 out of 67 metastatic sites (approximately 12% of all distant metastases) 2.
Clinical Presentation of Lung Metastases
When ovarian cancer metastasizes to the lungs, patients may present with:
- Respiratory symptoms (cough, dyspnea)
- Pleural effusions
- Hemoptysis (particularly with endobronchial involvement)
- Often asymptomatic and discovered on imaging 3
Risk Factors for Developing Distant Metastases
Several factors increase the risk of developing distant metastases, including lung metastases:
- Advanced stage at initial diagnosis
- High-grade tumors
- Lymph node involvement at diagnosis 2
Diagnosis of Lung Metastases
Diagnosis typically involves:
- Chest imaging (CT scan)
- Pleural fluid cytology when effusion is present
- Bronchoscopy with biopsy for endobronchial lesions
- Immunohistochemical staining to confirm ovarian origin (cytokeratin patterns) 4
Prognosis
The development of distant metastases, including lung metastases, significantly impacts prognosis:
- Median survival from diagnosis of distant metastasis is approximately 12 months 2
- The interval between initial ovarian cancer diagnosis and development of distant metastasis is a significant prognostic factor (longer interval correlates with better prognosis) 2
Clinical Implications
The presence of lung metastases from ovarian cancer:
- Indicates stage IV disease
- Requires systemic therapy approaches
- May benefit from multidisciplinary management including medical oncology, pulmonology, and thoracic surgery in selected cases
While ovarian cancer primarily spreads within the peritoneal cavity, clinicians should remain vigilant for pulmonary manifestations, as they represent a significant site of distant metastasis that impacts both treatment planning and prognosis.