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Case report
High-grade serous cancer of undetermined primary origin presenting as solitary inguinal lymph node enlargement
  1. Karen Dam1,
  2. Frederik Peeters2,
  3. Didier Verhoeven3,4 and
  4. Valerie Duwel5
  1. 1Gynaecology, AZ Monica, Antwerp, Belgium
  2. 2Gynaecology, AZ Klina, Brasschaat, Belgium
  3. 3Oncology, AZ Klina, Brasschaat, Belgium
  4. 4Department of Health Sciences, University of Antwerp, Antwerp, Belgium
  5. 5Pathology, AZ Klina, Brasschaat, Belgium
  1. Correspondence to Dr Karen Dam; karen.dam{at}azmonica.be

Abstract

A 62-year-old woman presented with unilateral inguinal lymphadenopathy, existing for several months. As it was initially thought to be lymphoma, the lymph node was resected. Pathology, however, revealed a metastasis of a high-grade papillary serous cancer, according to its stainings, most likely ovarian in origin. Further staging showed lymphadenopathies in the inguinofemoral, para-aortic and mediastinal regions. Consequently, the multidisciplinary oncologic meeting advised a diagnostic laparoscopy which showed no macroscopic spread within the abdomen. Pathological examination of biopsies as well as both ovaries showed no sign of ovarian cancer. The patient received standard chemotherapy, that is, carbo-Taxol-Avastin, to which she showed complete response after three cycles as shown on positron emission tomography–CT. A review of existing literature showed that this is a very unusual case of high-grade serous carcinoma, where no site of origin could be found.

  • gynaecological cancer
  • chemotherapy
  • pathology
  • surgical oncology

https://doi.org/10.1136/bcr-2020-239185

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    Footnotes

    • Contributors All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication. KD: conceptualisation (lead); writing—original draft (lead); formal analysis (lead); investigation (lead); visualisation (equal). FP: conceptualisation (equal); writing—review and editing (equal); formal analysis (equal), investigation (lead); investigation (equal); supervision (equal); visualisation (equal). DV: conceptualisation (equal); writing—review and editing (equal); formal analysis (equal); investigation (equal); supervision (equal); visualisation (equal). VD: conceptualisation (supporting); writing—review and editing (equal); formal analysis (equal); investigation (equal); supervision (supporting); visualisation (equal).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.