The clinical behavior of 124 leukemic ovarian tumors: clues for improving the poor prognosis.

The clinical behavior of acute leukemic tumors at each organ site must be recognized if relapse is to be prevented. The courses of 124 cases of leukemic ovarian tumors were analyzed with survival durations obtained from authors. Local expansive growth and invasion of contiguous organs similar to epithelial ovarian cancer was seen in both acute myeloid (AML) and lymphoid (ALL) leukemias. Overall, 56% survived 1 year. Tumors at other sites were clinically apparent on presentation in over half the cases without simultaneous marrow relapse, and next relapse was as common in extramedullary sites as in marrow. Leukemic ovarian tumors were generally resistant to chemotherapy, and lengthy survivals were seen most often after complete excision together with systemic therapy. This study documents similar behavior in AML and ALL tumors and that they are rarely isolated to a single ovary. It suggests that scanning could improve our ability to find and eradicate occult tumors which, because of chemoresistance, prevent the cure of leukemia for most patients who develop them.