Recurrent Metastasis of Epithelial Ovarian Cancer in Cervical, Submandibular and Suboccipital Lymph Nodes

Abstract

Ovarian carcinoma is the second most common gynecologic cancer and the leading cause of death from gynecologic malignancy. The management of recurrent ovarian cancer has been individualized. Reports of recurrence in supradiaphragmatic lymph nodes are rare. We describe the finding of metastatic tumor involving cervical, submandibular and suboccipital lymph nodes in a 77-year-old patient with ovarian carcinoma. Keywords: scalene lymph node, ovarian cancer, lymphadenopathy, recurrence doi: 10.3329/jom.v10i2.2830 J MEDICINE 2009; 10 : 128-131

Distant metastasis of serous carcinoma ovary: A Rare case report

“…The patient in our study presented with poor prognosis and died within one year. This is in accordance with David H Moore et al [9] who studied 10 patients with gynaecologic malignancies metastasising to breast, the most common gynaecologic malignancy found was ovarian cancer and majority of patients presenting with breast metastasis died within 1 year.…”

Isolated late recurrence of epithelial ovarian cancer in cervical lymph nodes

“…Surprisingly, after 16 years of follow-up, she presented with a metastatic lesion in the left inferior cervical area. Another case of left cervical area recurrence but with a shorter disease-free interval was reported by Mousawi et al [3] The late recurrence with aggressive behavior of the tumor and the rapid response to treatment could be explained by acquired mutations in the cancer cells which become rapidly proliferative and then highly responsive to chemotherapy. To the present authors' knowledge, this patient represents a unique reported case of epithelial ovarian cancer with late isolated recurrence in the cervical lymph nodes, with aggressive tumor behavior, and excellent rapid response to treatment.…”

“…Another possibility is through the subovarian plexus in the broad ligament to the obturator and pelvic lymph nodes. The third route is through the round ligament to the external iliac and inguinal lymph nodes [3]. In advanced stages, lymph node involvement commonly occurs.…”

“…Spread of cancer cells through the lymphatic channels of the diaphragm and through the retroperitoneal lymph nodes, can lead to dissemination above the diaphragm. Extra-abdominal lymph nodes are rarely involved [2,3]. Supradiaphragmatic lymph node metastasis has been described only in very few cases in the literature.…”