Axillary lymph‐node metastases as the primary presentation of high‐grade serous ovarian carcinoma: A case report

Abstract

We reported a female presented with an initial diagnosis of metastatic axillary lymph‐node carcinoma that comprehensive assessments revealed a definitive diagnosis of high‐grade serous ovarian carcinoma as the primary tumor.

Left Axilla Adenocarcinoma of Unknown Origin

“…Although metastatic ovarian or tubal serous carcinoma typically first spreads locally within the abdomen or peritoneum, distal extra-abdominal involvement is well established . An isolated axillary mass rarely presents as the initial sign of ovarian or tubal serous carcinoma, and there are few cases reported . Unlike other patients, this patient was initially treated with neoadjuvant chemotherapy with a presumptive diagnosis of an occult breast cancer with axillary metastasis.…”

“…1 An isolated axillary mass rarely presents as the initial sign of ovarian or tubal serous carcinoma, and there are few cases reported. [2][3][4] Unlike other patients, this patient was initially treated with neoadjuvant chemotherapy with a presumptive diagnosis of an occult breast cancer with axillary metastasis. After histopathologic reassessment and additional immunostaining at our institution, the treatment plan was adjusted accordingly.…”

Axillary Lymph Node Metastasis from Ovarian Carcinoma: A Systematic Review of the Literature

“…Thirteen cases manifested the axillary lymph node metastasis as an initial presentation of the disease, either as the first symptom that led to the diagnosis or as lymph node enlargement through image study during the work-up for an ovarian mass [6,7,9,14,15,17,18,20,[22][23][24]. Twelve cases exhibited lymph node metastasis as a recurrence of a previously treated ovarian carcinoma [8,[10][11][12][13]16,19,21,23,25,26].…”

“…Clinically, three cases presented with abnormal findings in breast screening evaluation [6,15,17]. Four presented with enlargement in the axillary region [9,14,20,24]. One patient presented with bilateral mastitis [7].…”

“…A pelvic imaging study performed during the investigation of these cases showed the presence of ovarian masses without further abnormal findings in two patients [6,14]. In eight cases, there was peritoneal and/or omental involvement in addition to [15,17,18,22,23] or without [7,22] an ovarian tumor; five cases reported the presence of ascites [7,17,18,23,24], while retroperitoneal lymph node enlargement was found in three patients [20,22,23]. In the case reported by Moustafa and Benyon [9], ovarian and para-aortic lymph node enlargement was noted.…”