Metastatic carcinoma

Clinical History
This 47 year old woman was admitted with terminal carcinomatosis. On examination a hard liver and a right pelvic mass were palpable. She had been ill with constitutional symptoms for months and she finally sought medical attention. She was admitted for palliative care and died shortly afterwards.

Pathology
The left lung has been sliced longitudinally to display the cut surface. Multiple pale tumour nodules of varying size are scattered throughout the lung substance. Near the hilum several nodules are confluent. The hilar lymph nodes contain pale tumour tissue. Small tumour nodules can be seen beneath the thickened pleura. Histologically these were metastatic deposits of adenocarcinoma. At post-mortem there was an adeno-carcinoma of ovary, with metastases in lungs, heart, liver and pericardium.

Further Information
Pulmonary metastases are more common than primary lung cancer. Malignant disease arising anywhere in the body may spread to the lungs. Sarcomas usually metastasize by the bloodstream, and carcinomas spread either via the bloodstream or the lymphatic system or both.