2024-Abstract 13

Presenter

My name is Jacob and I am a third-year Neuropathology resident at the Schulich School of Medicine and Dentistry in London, ON, Canada. Prior to this, I attended medical school at the same, where I started to cultivate a still-growing interest and joy in all things neuropathology. My sincere thanks for the opportunity to attend the CANP 2024 Annual Meeting, and I hope to see you there!
My research endeavors currently include, but are not limited to, the pathophysiology of leukoencephalopathies, mechanistic factors behind malformations of cortical development, and comparison of manual vs. digital pathology methods in interpreting immunohistochemical indices.

Authors

Mimi Zhang 1, Jacob A. Houpt 1, Lee-Cyn Ang 1

1 Department of Pathology and Laboratory Medicine,
London Health Sciences Centre, London, ON, Canada.

CanMEDS:
Medical Expert (the integrating role), Communicator, Scholar

Features Of Central Nervous System Metastases By Neoplasms Of Gynecological Origin

Abstract

Central nervous system involvement by metastasis from extra-axial malignancies represent the most common CNS neoplasms in adults, with primary lung, breast, renal, and colorectal carcinomas and cutaneous melanomas representing the majority of such. CNS metastases of gynecological origin are relatively rare – making up no more than 3% of cases of CNS metastases and occurring in as few as 0.6% of gynecological cancer patients. All previous cases of CNS metastases at London Health Sciences Centre (LHSC) were screened for keywords related to ovarian, endometrial, and cervical origin. Cases where another possible primary was speculated to be more likely or cases lacking a known or suspected primary gynecological malignancy (based on previous pathology or imaging investigations) were excluded. This yielded 6 and 15 cases of metastases compatible with ovarian and endometrial primaries, respectively. Of the 6 ovarian cases, 3 (50%) were associated with poorly-differentiated ovarian adenocarcinoma primaries, 2 with high-grade serous ovarian adenocarcinomas, and a single case of mixed clear-cell and serous ovarian adenocarcinoma in which the serous component predominated in the metastasis. Within the 15 cases of uterine primaries, 4 were associated with endometrioid, 1 with serous, 1 with mixed, and 4 with poorly-differentiated adenocarcinomas. The remaining cases included a leiomyosarcoma and 4 carcinosarcomas, the latter of which featured a predominating epithelial component in 2 cases, dual components in a single case, and a rhabdomyosarcoma component in the final case. Relative to other primary malignancies, poorly-differentiated primary carcinomas are over-represented in metastases from gynecological origin (both in ovarian and non-ovarian cases). 

References
DOI: 10.1016/j.currproblcancer.2022.100918
DOI: 10.1136/ijgc-2023-ESGO.506
DOI: 10.3390/cancers13030519