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2022-RA-1602-ESGO Cutaneous metastasis in epithelial ovarian cancer: experience from a tertiary care cancer institute
  1. Divya Sehra1,
  2. Seema Singhal2,
  3. Neerja Bhatla2,
  4. Jyoti Meena2,
  5. Anju Singh2,
  6. Rajesh Kumari2 and
  7. Sarita Sharma2
  1. 1Gynae Oncology, AIIMS, Delhi, India
  2. 2AIIMS, Delhi, India


Introduction/Background Epithelial Ovarian cancer (EOC) usually metastasizes via direct, lymphatic and haematogenous routes and usual sites of spread are peritoneum, omentum and lymph nodes. Cutaneous metastases in EOC are relatively rare, with incidence reported to be 0.9–5.8%. However, more cases are being reported in recent literature, probably due to advancement in therapeutics.

Methodology Records of patients with EOC who presented at a tertiary cancer care institute in India during the time period 2020–2022 were reviewed. The clinicopathological features, management and outcomes of patients with cutaneous metastasis were analysed.

Results Three cases of cutaneous metastasis were identified, out of which one presented in the upfront setting and the other two in the recurrent. Age at presentation ranged from 39–74 years. All three had high grade serous adenocarcinomas. Patient in upfront setting presented with Sister Joseph nodule (SJN), with umbilical lump and discharge being the initial symptom. She underwent further investigations, neoadjuvant chemotherapy and surgical cytoreduction and umbilectomy, she is currently disease free after 1 year of treatment. In the other two cases, the cutaneous metastases presented as recurrent disease after 9 months and 8 years of completion of therapy, respectively. The sites of these metastasis were face and scalp respectively. Both the cases were managed using second line chemotherapy (gemcitabine, cisplatin, bevacuzimab) and are currently doing well.

Conclusion Detailed history and meticulous systemic examination including skin examination can be crucial for early detection of metastasis from carcinoma ovary. while SJN is a well known entity, rare sites such as face and scalp should be kept in high index of suspicion.

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