Metastatic Skin Lesions on Lower Extremities in a Patient with Recurrent Serous Papillary Ovarian Carcinoma: A Case Report and Literature Review

Abstract

Clinical observation of skin metastasis in ovarian cancer cases is relatively uncommon. And distant metastatic skin lesions including the extremities are much rarer still as most metastatic skin lesions are located in the skin in the abdominal wall adjacent to where the primary ovarian tumors exist. We report the case of a 60-year-old woman who presented skin lesions on both lower extremities as a consequence of the metastasis of serous papillary adenocarcinoma of the ovary. She presented with erythematous and painful cutaneous nodules on both upper legs and in the inguinal area 42 months after initial diagnosis of ovarian cancer. Skin biopsy revealed metastasis of adenocarcinoma in the dermis. She was treated with surgical excision and systemic chemotherapy. Literature review has suggested that a combined modality approach including surgical excision and chemotherapy may be useful in the management of skin metastases due to ovarian cancer.

Large Cell Neuroendocrine Carcinoma of the Ovary and its Skin Metastases: A case report and review of the literature Ovarian Large Cell Neuroendocrine Carcinoma

“…As seen in the patient, non-abdominal skin lesions may have resulted from tumour embolus through the lymphatic or haematogenous spread. In the literature, it has been reported that the time between the diagnosis of ovarian cancer and the documentation of cutaneous involvement is the most important prognostic factor affecting survival (26,27). We lost our patient following the skin metastasis that emerged soon after she was diagnosed due to the progression of the disease.…”

“…Generally, the clinical observation of skin metastasis in epitelial ovarian cancer is uncommon; its incidence ranges from 1.9% to 5.1% (26). Most metastatic skin lesions occur in skin adjacent to the primary ovarian cancer including the abdominal wall (27,28). Several mechanisms may explain the occurrence of skin metastasis in the abdominal wall, such as the direct spread of tumour cells from the underlying growth, accidental implantation associated with surgery, or the contiguous spread of tumour cells through lymphatic or haematogenous routes (26,28).…”

“…Metastatic skin lesions on extremities are even more rare; it has been reported that only 12% of epithelial ovarian carcinoma skin metastases occur on the limbs (27,29). Skin metastasis due to LCNEC of the ovary has not been previously reported.…”

“…The patient was treated with surgical excision and systemic chemotherapy. In general, the literature on ovarian cancer has suggested that a combined modality approach including surgical excision and chemotherapy may be useful in the management of skin metastases (27,29). Hence, surgery and chemotherapy may be recommended for palliation in patients with LCNEC of the ovary.…”

“…Generally, in epithelial ovarian cancers, the most common sites of distant metastasis are the pleura, liver, lung and lymph nodes (26). The clinical observation of skin metastasis in ovarian cancer cases is uncommon, occurring in only 3.5% of patients (26,27). The incidence of skin metastasis from large cell neuroendocrine ovarian tumours is unknown, because none of the 45 reported cases of LCNEC of the ovary had skin metastases (Table).…”