Ovarian cancer with metastatic deposits in the cervix, vagina, or vulva preceding primary cytoreductive surgery.

Ovarian cancer rarely metastasizes to the uterine cervix, vagina, or vulva. Equally important is the rarity of the disease in these sites at initial presentation. In a review of 148 patients with FIGO Stage III or IV ovarian cancer, 7 patients had cervical metastatic deposits. Four were due to direct extension of the primary; the 3 patients who had truly metastatic deposits all presented with cervical cytology showing the presence of adenocarcinoma cells. All the patients with cervical metastases had associated malignant ascites, retroperitoneal lymph node involvement, and significant peritoneal carcinomatosis. Their median survival was 4.4 months. There was no significant difference in survival between the patients who had truly metastatic deposits compared with those in whom the cervical disease was due to direct extension of the ovarian cancer. One patient presented with a vaginal secondary deposit 11 months prior to definitive diagnosis, and 1 had a vulval metastasis at initial examination. The patient with the vaginal deposit is still alive with no clinically detectable disease 27 months after initial presentation, while the patient with the vulval deposit had significant distant metastases at the time of presentation and died preoperatively.