Introduction/Background Tumoral dissemination of ovarian cancer most commonly occurs through the intra-peritoneal route. Nevertheless, although rare, ovarian cancer may also metastasize through lymphatic channels, usually into pelvic and retroperitoneal lymph nodes and even rarely in extra-abdominal lymph nodes. We report a case of a woman diagnosed with clear cell carcinoma of the ovaries, recurring with left supraclavicular lymph node metastases.
Methodology A 53-year old woman was diagnosed with clear cell carcinoma of the ovaries, stage IC, elsewhere, where she underwent a total hysterectomy with bilateral salpingo-oophorectomy, omentectomy and lymph node pelvic resection.
Results She was admitted in our hospital, where she underwent 6 cycles of second line chemotherapy with carboplatin and paclitaxel. She remained disease free for the following 21 months, when lymph node disease was revealed in PET-CT examination. Resection and examination of left supraclavicular lymph nodes revealed secondary involvement by ovarian clear cell carcinoma. She received three additional cycles of carboplatin and paclitaxel. The woman remained hospitalized with B symptoms, for five weeks, when after investigation her symptoms were attributed to her disease. She continued with hycamtin every week, as a second line therapy, for seven cycles. Because of anaemia and thrombopenia, she underwent a bone marrow biopsy, where a massive infiltration by carcinoma cells was revealed. She underwent a third-line chemotherapy with cisplatin and bevacizumab for almost a month. After an initial recovery, the fever relapsed. A fourth line chemotherapy was recommended, which the patient refused. She returned after four months with end-stage disease and succumbed one month later.
Conclusion Reports in the literature on tumoral spread of ovarian cancer to the supraclavicular nodes are rare, however this possible site of metastatic involvement has to be kept in mind by oncologists. Histology remains the only means in identifying specific tumor types and the site of origin.
Disclosure Nothing to disclose.
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