Isolated Axillary Lymph Node Recurrence from Serous Ovarian Carcinoma: A Case Report

Yıl 2023, Cilt: 25 Sayı: 1, 96 - 98, 30.04.2023

Pelin Höbek , M.anıl Onan

https://doi.org/10.18678/dtfd.1207021

Cited By: 1

Öz

Ovarian cancer is the most mortal gynecological malignancy among women worldwide. The appropriate treatment protocol is cytoreductive surgery and the main aim is to remove all primary carcinoma focus and all metastatic lesions. A 37 years old woman (gravida 5, para 3) presented with complaints of abdominal distension. During the gynecological examination, bilateral adnexal masses in the solid structure were observed. Staging surgery was performed and 8 cycles of adjuvant chemotherapy regimen were given. A pathological axillary lymph node was detected in the positron emission tomography-computed tomography (PET/CT) imaging at the follow-up 6 months after the end of the chemotherapy regimen. The biopsy result from the axillary lymph node was reported as serous carcinoma metastasis. Metastasis of ovarian carcinoma to the axillary lymph node is uncommon and has a poor prognosis. High-grade ovarian serous carcinoma with axillary lymph node metastasis was presented in this case report.

Anahtar Kelimeler

Ovarian Neoplasms, Cystadenocarcinoma, Serous, Neoplasm Metastasis

Seröz Over Karsinomunun İzole Aksiller Lenf Nodunda Nüksü: Olgu Sunumu

Öz

Over kanseri, dünya çapında kadınlar arasında en ölümcül seyreden jinekolojik malignitedir. Uygun tedavi protokolü sitoredüktif cerrahidir ve asıl amaç tüm primer karsinom odağını ve tüm metastatik lezyonları çıkarmaktır. 37 yaşında kadın hasta (gravida 5, para 3) karın şişliği nedeniyle başvurdu. Jinekolojik muayenede bilateral solid yapıdaki adneksiyal kitleler izlendi. Hastaya evreleme cerrahisi yapıldı ve 8 kür adjuvan kemoterapi rejimi verildi. Kemoterapi rejimi bitiminden sonraki 6. ay kontrolünde, pozitron emisyon tomografi-bilgisayarlı tomografi (positron emission tomography and computed tomography, PET/CT) görüntülemesinde patolojik görünümde aksiller lenf nodu saptandı. Aksiller lenf nodundan alınan biyopsi sonucu seröz karsinom metastazı olarak raporlandı. Over karsinomunum aksiller lenf nodu metastazı oldukça nadirdir ve kötü prognostik bir işaret olarak kabul edilir. Bu vaka raporunda aksiller lenf nodu metastazı olan yüksek dereceli over seröz karsinomu sunulmuştur.

Anahtar Kelimeler

over tümörleri, kistadenokarsinom, seröz, Tümör metastazı

Kaynakça

• Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49.
• Jayson GC, Kohn EC, Kitchener HC, Ledermann JA. Ovarian cancer. Lancet. 2014;384(9951):1376-88.
• Rahman M, Nakayama K, Rahman MT, Katagiri H, Ishibashi T, Miyazaki K. Enlarged Virchow's node as an initial complaint of serous ovarian adenocarcinoma. Eur J Gynaecol Oncol. 2012;33(5):546-8.
• Ceccarelli F, Barberi S, Pontesilli A, Zancla S, Ranieri E. Ovarian carcinoma presenting with axillary lymph node metastasis: a case report. Eur J Gynaecol Oncol. 2011;32(2):237-9.
• Thomakos N, Diakosavvas M, Machairiotis N, Fasoulakis Z, Zarogoulidis P, Rodolakis A. Rare distant metastatic disease of ovarian and peritoneal carcinomatosis: a review of the literature. Cancers (Basel). 2019;11(8):1044.
• Goyal H, Mattoo VK, Singla U. Isolated axillary lymph node metastasis from serous ovarian cancer. Case Rep Oncol Med. 2012;2012:307567.
• Hynninen J, Auranen A, Carpén O, Dean K, Seppänen M, Kemppainen J, et al. FDG PET/CT in staging of advanced epithelial ovarian cancer: frequency of supradiaphragmatic lymph node metastasis challenges the traditional pattern of disease spread. Gynecol Oncol. 2012;126(1):64-8.
• Adler E, Mhawech-Fauceglia P, Gayther SA, Lawrenson K. PAX8 expression in ovarian surface epithelial cells. Hum Pathol. 2015;46(7):948-56.
• Harter P, Sehouli J, Vergote I, Ferron G, Reuss A, Meier W, et al. Randomized trial of cytoreductive surgery for relapsed ovarian cancer. N Engl J Med. 2021;385(23):2123-31.
• 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(12):1646-51.
• Blanchard P, Plantade A, Pagès C, Afchain P, Louvet C, Tournigand C, et al. Isolated lymph node relapse of epithelial ovarian carcinoma: outcomes and prognostic factors. Gynecol Oncol. 2007;104(1):41-5.