Ovarian Papillary Serous Cancer Recurrence with Ipsilateral Isolated Axillary Lymph node Metastasis as an Unusual Presentation: A case Report

Document Type : Case report

Authors

1 Fellowship of Gyneco-oncology, Department of Obstetrics and Gynecology, Firoozgar Clinical Research Development Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

2 Assistant Professor, Department of Radiotherapy and Oncology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 M.Sc. in Clinical Psychology, Firoozgar Clinical Research and Development Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

4 Resident in genecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: From among gynecologic cancers, epithelial ovarian cancer (EOC) is the leading cause of mortalities due to gynecologic cancers in the United States, constituting 3.6% of all types of gynecologic cancers. A major reason for this poor treatment outcome is that most EOC patients are frequently diagnosed in advanced stages of the disease. A standard management for EOC patients involves a primary cytoreductive surgery followed by adjuvant chemotherapy if needed. However, primary breast cancer is one of the most common malignancies in women, and metastasis of other cancers to the breast is relatively rare.
Case Presentation: Here, we report the case of a 70-year-old patient who five years ago had undergone laparotomy due to post-menopausal bleeding, adnexal mass, and elevated CA125. With the diagnosis of metastatic papillary serous, she underwent primary cytoreductive surgery and adjuvant chemotherapy. Regarding the history of ovarian cancer diagnosed five years ago, and further examination of this suspicious lymph node, and rejection of the risk of breast cancer, the patient was examined for the risk of metastasis. In biopsy and immunohistochemistry study, metastatic lymph node was diagnosed with the origin of epithelial ovarian cancer, and the patient was treated with beta-taxol + carboplatin, and the size of the axillary lymph node shrank.
 Conclusion: Regarding the unusual nature of recurrence of ovarian cancer as isolated axillary lymph node involvement, this report emphasizes the importance of considering metastasis in the axilla and its differential diagnosis from breast cancer in patients with a history of ovarian cancer, since prognoses and treatments are different for each diagnosis.
 

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References

  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60(5):277-300.
  2. Fathalla MF. Factors in the causation and incidence of ovarian cancer. Obstet Gynecol Surv 1972; 27(11):751-68.
  3. Fader AN, Rose PG. Role of surgery in ovarian carcinoma. J Clin Oncol 2007; 25(20):2873-83.
  4. Markman M, Bundy BN, Alberts DS, Fowler JM, Clark-Pearson DL, Carson LF, et al. Phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately high-dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Group, and Eastern Cooperative Oncology Group. J Clin Oncol 2001; 19(4):1001-7.
  5. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015; 65(1):5-29.
  6. Mohamadianamiri M. Dermatomyositis as a feature of ovarian cancer: a case report. Sci J Kurdistan Univ Med Sci 2018; 22:110-7. (Persian).
  7. Ashrafganjoei T, Mohamadian AM, Zeynalzadeh M. Uterine carcinosarcoma associated with tamoxifen use in a menopausal patient: a case report. J Babol Univ Med Sci 2015; 17(12):71-4. (Persian).
  8. Kamura T, Jeon JD. Lymph node metastasis in a gynecologic malignancy. Yonsei Med J 2002; 43(6):783-91.
  9. Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, et al. Distant metastases in ovarian carcinoma. Int J Gynecol Cancer 2003; 13(2):125-9.
  10. Zang RY, Zhang ZY, Cai SM, Tang MQ, Chen J, Li ZT. Epithelial ovarian cancer presenting initially with extraabdominal or intrahepatic metastases: a preliminary report of 25 cases and literature review. Am J Clin Oncol 2000; 23(4):416-9.
  11. Raptis S, Kanbour AI, Dusenbery D, Kanbour‐Shakir A. Fine‐needle aspiration cytology of metastatic ovarian carcinoma to the breast. Diagn Cytopathol 1996; 15(1):1-6.
  12. Mason C, Yokubaitis K, Hamilton R, Oza U, Shah Z, Spigel J, et al. Unusual presentation of metastatic ovarian carcinoma as an enlarged intramammary lymph node. Baylor Univ Med Center Proc 2015; 28(3):386-8. 
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 21, Issue 5
July 2018
Pages 108-111

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