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

Document Type : Case report


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


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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