J Breast Cancer.  2008 Jun;11(2):102-105. 10.4048/jbc.2008.11.2.102.

A Recurrence of Ovarian Carcinoma Presenting as Only Axillary Lymphatic Metastasis: A Case Report

• Woo SU
• Kim HE

• KMID: 2241939
• DOI: http://doi.org/10.4048/jbc.2008.11.2.102

Abstract

Ovarian carcinoma usually metastasizes to the peritoneal cavity and the regional lymph nodes. While the peritoneal metastases if often widespread, metastases beyond the peritoneal cavity including axillary lymph nodes are uncommon. A recurrence of ovarian carcinoma in only the axillary lymph node is also a rare case. We report here on an axillary lymphatic metastasis as a result of recurrence of ovarian carcinoma in a 43-yr-old woman. Six years after the initial operation for ovarian carcinoma, multiple lymphatic metastases in the right axilla were noted as a palpable axillary masses. There are few previous reports about ovarian carcinoma that metastatized to the axillary lymph nodes. It must be differentiated from breast carcinoma because the treatment and prognosis of metastatic ovarian carcinoma differ from those of primary breast carcinoma.

Keyword

Ovarian cacinoma; Axillary lymph node; Recurrence; Metastasis

MeSH Terms

Axilla
Breast
Female
Humans
Lymph Nodes
Lymphatic Metastasis
Neoplasm Metastasis
Peritoneal Cavity
Prognosis
Recurrence

Figure

• 

  Fig 1 Computed tomography scan showed the multiple enlarged lymphadenopathy in the right axilla.

• 

  Fig 2 Papillary serous cystadenocarcinoma in oophrectomy specimen (Hematoxylin-eosin magnification ×200).

• 

  Fig 3 The slide shows axillary lymph node containing metastatic papillary serous carcinoma with histologic features similar to the previous ovarian carcinoma (Hematoxylin-eosin stain, magnification ×200).

Reference

1. Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001. 51:15–36.

2. Hajdu SI, Urban JA. Cancers metastatic to the breast. Cancer. 1972. 29:1691–1696.

3. Sandison AT. Metastatic tumours in the breast. Br J Surg. 1959. 47:54–58.

4. Euscher ED, Silva EG, Deavers MT, Elishaev E, Gershenson DM, Malpica A. Serous carcinoma of the ovary, fallopian tube, or peritoneum presenting as lymphadenopathy. Am J Surg Pathol. 2004. 28:1217–1223.

5. Hockstein S, Keh P, Lurain JR, Fishman DA. Ovarian carcinoma initially presenting as metastatic axillary lymphadenopathy. Gynecol Oncol. 1997. 65:543–547.

6. Recine MA, Deavers MT, Middleton LP, Silva EG, Malpica A. Serous carcinoma of the ovary and peritoneum with metastases to the breast and axillary lymph nodes: a potential pitfall. Am J Surg Pathol. 2004. 28:1646–1651.

7. Bonnefoi H, A'Hern RP, Fisher C, Macfarlane V, Barton D, Blake P, et al. Natural history of stage IV epithelial ovarian cancer. J Clin Oncol. 1999. 17:767–775.

8. Cormio G, Rossi C, Cazzolla A, Resta L, Loverro G, Greco P, et al. Distant metastases in ovarian carcinoma. Int J Gynecol Cancer. 2003. 13:125–129.

9. Ro DY, Kim YW, Kim TE, Lee HY, Chung DS, Lee A. A case of cerellar metastases from ovarian carcinoma. Korean J Obstet Gynecol. 2003. 46:153–157.

10. Gemignani ML, Chi DS, Gurin CC, Curtin JP, Barakat RR. Splenectomy in recurrent epithelial ovarian cancer. Gynecol Oncol. 1999. 72:407–410.

11. de Andrade JM, Marana HR, Sarmento Filho JM, Murta EF, Velludo MA, Bighetti S. Differential diagnosis of axillary masses. Tumori. 1996. 82:596–599.

12. Tot T. Cytokeratins 20 and 7 as biomarkers: usefulness in discriminating primary from metastatic adenocarcinoma. Eur J Cancer. 2002. 38:758–763.

13. Al-Hussaini M, Stockman A, Foster H, McCluggage WG. WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology. 2004. 44:109–115.

14. Wick MR, Lillemoe TJ, Copland GT, Swanson PE, Manivel JC, Kiang DT. Gross cystic disease fluid protein-15 as a marker for breast cancer: immunohistochemical analysis of 690 human neoplasms and comparison with alpha-lactalbumin. Hum Pathol. 1989. 20:281–287.

15. Pavlidis N, Briasoulis E, Hainsworth J, Greco FA. Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer. 2003. 39:1990–2005.