A rare case of recurrent ovarian cancer presenting as a round ligament metastasis

Occult ovarian high-grade serous carcinoma presenting as isolated inguinal lymph node metastasis: A case report and literature review

Superficial inguinal lymph node (SILN) metastasis is rare in ovarian cancer, particularly as an isolated presentation without peritoneal dissemination. Here we report a case of solitary SILN metastasis in a patient with high-grade serous carcinoma of ovarian cancer and review previously reported cases from literature. A 58-year-old woman presented with isolated right groin swelling (approximately 4 cm), excisional biopsy suggested ovarian origin but comprehensive imaging and laparoscopy failed to identify a primary intra-abdominal tumor, and postoperative pathology confirmed no evidence of ovarian involvement. Following multidisciplinary consultation, the patient received six cycles of paclitaxel (175 mg/m²) plus carboplatin (AUC-5) chemotherapy (21-day intervals). Remarkably, five years post-treatment, she remains disease-free, highlighting the potential for favorable outcomes even in rare metastatic presentations. This case demonstrates that ovarian cancer is not a disease confined to the intra-peritoneal cavity; SILN metastasis might occur in rare cases possibly via lymphatic and/or hematogenous spread route under specific circumstances. Further investigations related to risk factors and metastatic patterns are warranted to explore the mechanisms and clinical implications of isolated SILN metastasis in ovarian cancer.

Surgical Anatomy of the Liver-Significance in Ovarian Cancer Surgery

INTRODUCTION

Ovarian cancer is the leading cause of death among all gynecological malignancies. Most patients present with an advanced stage of the disease. The routes of spread in ovarian cancer include peritoneal dissemination, direct invasion, and lymphatic or hematogenous spread, with peritoneal and lymphatic spread being the most common among them. The flow direction of the peritoneal fluid makes the right subphrenic space a target site for peritoneal metastases, and the most frequently affected anatomical area in advanced cases is the right upper quadrant. Complete cytoreduction with no macroscopically visible disease is the most important prognostic factor.

METHODS

We reviewed published clinical anatomy reports associated with surgery of the liver in cases of advanced ovarian cancer.

RESULTS

The disease could disseminate anatomical areas, where complex surgery is required-Morrison's pouch, the liver surface, or porta hepatis. The aim of the present article is to emphasize and delineate the gross anatomy of the liver and its surgical application for oncogynecologists. Moreover, the association between the gross and microscopic anatomy of the liver is discussed. Additionally, the vascular supply and variations of the liver are clearly described.

CONCLUSIONS

Oncogynecologists performing liver mobilization, diaphragmatic stripping, and porta hepatis dissection must have a thorough knowledge of liver anatomy, including morphology, variations, functional status, potential diagnostic imaging mistakes, and anatomical limits of dissection.

Left inguinal adenopathy two years after cytoreductive surgery: a rare sign of recurrence

Ovarian cancer is the second most common gynecological cancer in the Western world. Despite a good response to treatment, most patients with ovarian cancer will relapse. The abdominal, pelvic, and retroperitoneal cavities represent the most common sites of ovarian cancer recurrence, with inguinal lymph node involvement rarely reported. Herein we report the case of a 48-year-old Caucasian female who underwent successful surgical and chemotherapy treatment for ovarian epithelial cancer. Two years later, the patient was found to have painless left inguinal adenopathy, which was subsequently found to be metastatic ovarian cancer. CA-125 levels were elevated despite the lack of any foci of metabolically active tissue on imaging. Inguinal lymph node involvement is a rare sign of ovarian cancer. Despite that, it is essential to consider ovarian cancer in the differential diagnosis for inguinal lymphadenopathy in a female patient.