Introduction/Background*Some studies have highlighted the imaging finding of vaccine-associated lymphadenopathies post-Covid19 vaccines. That may have a direct impact on the diagnostic accuracy of oncologic patients. Therefore, imaging experts suggest postponing imaging explorations to 6 weeks away from vaccination. Nevertheless to postpone imaging can interfere in assessment of disease extent or clinical response of these patients. We aimed to emphasize the relevance of these findings in ovarian cancer (OC) patients.

Methodology We report three cases of asymptomatic OC patients that presented enlarged lymphadenopathies in CT scans and who have received at least one dose of mRNA Covid-19 vaccine at 6, 8 and 28days prior to the CT examination, respectively.

Result(s)*Two of them were considered as having benign vaccine-associated lymphadenopathies as they presented right supraclavicular and intrapulmonary lymphadenopathies with no other clinical findings, nevertheless a new CT scan was performed 3 months later to reassure diagnostic. The third patient, one year after being diagnosed by EOC, was diagnosed by Lymphoma. After finishing treatment, a PET/CT SCAN to response evaluation was performed, 6 days after of COVID-19 vaccination. All tumoral nodes except one hypermetabolic lymph located at the lateral side of left Iliac Artery disappeared. This lymph node was considered as either no responsive or relapsed from OC, and less likely vaccine-associated. After being resected a high grade carcinoma was found.

Conclusion*The incidence of lymphadenopathies in vaccinated patients raises a challenge in the interpretation of imaging of OC patients. Present cases emphasize the need for an accurate clinical evaluation encompassing the type and timing of Covid-19 vaccination. This would also allow avoiding imaging misinterpretations and unnecessary further assessment. Evidence-based guidelines are needed as postponing imaging controls to 6 weeks away from vaccination may be problematic in assessment of clinical response in treated OC patients or newly diagnosed patients.

The authors declare no conflicts of interest. None received grant support for this study neither for related clinical or research activity