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Our observations indicate that the menopausal status of a patient, the anatomic location or the histologic differentiation of a primary adenocarcinoma of the colorectal area does not seem to affect the incidence of ovarian metastases. Tumors initially classified as Dukes' B2 and, later, associated with ovarian metastases have consistently poorer prognosis. The reason that ovarian metastases attain a relatively large size, while other metastatic foci remain small, is unknown. Regardless of the surgical findings, patients with ovarian metastases from a primary adenocarcinoma of the colorectal area tend to have short survival with widespread distribution of the tumors at death. This would suggest that these metastases occur primarily by the hematogenous route rather than by an orderly invasion to contiguous structures and draining lymph nodes. Patients with resectable solitary ovarian metastases and prospectives of cure must be a rare event in carcinoma of the colon and rectum.

The three cases herein reported concern metachronous ovarian metastases from primary adenocarcinomas of the colon associated with mesothelial cysts. Although the etiology of these cysts remains obscure, the cases were of interest because the cysts did not contain tumor cells despite the intimate relationship to the tumor. Metastases were localized to the ovary and were resectable. All signs and symptoms disappeared, affording excellent palliation and an extended survival.