Metastatic malignant non-cervical gynecological tumors involving the genitourinary system: A contemporary clinicopathologic analysis of 27 patients

Yulin Haw; Adeboye O Osunkoya

doi:10.1016/j.humpath.2026.106193

Metastatic malignant non-cervical gynecological tumors involving the genitourinary system: A contemporary clinicopathologic analysis of 27 patients

Hum Pathol. 2026 Jun 3:176:106193. doi: 10.1016/j.humpath.2026.106193. Online ahead of print.

Authors

Yulin Haw¹, Adeboye O Osunkoya²

Affiliations

¹ Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA.
² Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA; Winship Cancer Institute of Emory University, Atlanta, GA, USA; Department of Urology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pathology, Veterans Affairs Medical Center, Decatur, GA, USA. Electronic address: adeboye.osunkoya@emory.edu.

PMID: 42242397
DOI: 10.1016/j.humpath.2026.106193

Abstract

Introduction: Metastatic non-cervical gynecological tumors involving the genitourinary system have not been well characterized.

Materials and methods: A search was conducted through our urologic pathology and expert consultation files of the senior author. Clinical data was extracted from electronic medical records.

Results: Twenty-seven patients were included in the study. Mean patient age was 60 years (range: 29-81 years). The most common site of origin was the ovary (19/27, 70%) with predominantly serous carcinomas. The second most common site was the endometrium (6/27, 22%), predominantly consisting of endometrioid adenocarcinoma (3/6, 50%). Other sites of origin included fallopian tube (2/27, 8%). The most common genitourinary system site of involvement was bladder (16/27, 59%). Other sites included peritoneum overlying the bladder (9/27, 33%), perivesical soft tissue (1/27, 4%), and perinephric soft tissue (1/27, 4%). The stages of the primary tumors in patients with resection specimens were originally categorized as pT2 in 3/25 (12%) and pT3 in 22/25 (88%). Nodal status in patients with lymph node excisions was pN1 in 9/10 (90%) and pN0 in 1/10 (10%). Follow-up data was available for 19/27 (70%) patients and 8/19 (42%) died of widespread metastatic disease, with a median survival of 48 months (range: 8-135 months).

Conclusions: This is one of the largest studies to date of metastatic non-cervical gynecological tumors involving the genitourinary system. Our study demonstrates that these tumors most commonly arise from the ovary and endometrium, with the bladder representing the predominant genitourinary system site of secondary involvement. Pathologists need to be aware of potential diagnostic pitfalls associated with these tumors that may occasionally mimic primary bladder neoplasms with divergent differentiation.

Keywords: Bladder metastases; Endometrioid adenocarcinoma; Fallopian tube carcinoma; Genitourinary system; Metastatic gynecologic tumors; Peritoneal carcinomatosis; Perivesical extension; Serous carcinoma; Transcoelomic spread.