A rare case of recurrent ovarian cancer presenting as a round ligament metastasis
- PDF / 392,098 Bytes
- 3 Pages / 595.28 x 793.7 pts Page_size
- 29 Downloads / 191 Views
WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
A rare case of recurrent ovarian cancer presenting as a round ligament metastasis Shinichi Togami*, Tomoyasu Kato, Takateru Oi, Mitsuya Ishikawa, Takashi Onda, Shun-ichi Ikeda and Takahiro Kasamatsu
Abstract We report a rare case of recurrent ovarian cancer presenting as a round ligament metastasis. A 44-year-old woman presented with a lower abdominal mass. Computed tomography showed a pelvic mass. Primary surgery was performed. A histopathological examination showed an ovarian serous adenocarcinoma of Stage IIIb. The patient received 6 cycles of paclitaxel and carboplatin. Almost 2 years after the initial operation, the patient noticed a left inguinal mass. Computed tomography showed a left inguinal mass, 18 mm in size. An excisional biopsy was performed and the tumor was found to originate in the left round ligament. A histopathological examination showed serous adenocarcinoma and there was no evidence of lymph node tissue. Recurrence of ovarian cancer in the round ligament is extremely rare. This unique case suggests, however, that the round ligament in rare cases may be a recurrence site for ovarian cancer, and that accurate differentiation including confirmation by diagnostic imaging and excisional biopsy, is necessary for a definitive pathological diagnosis. Keywords: diagnosis, inguinal mass, ovarian cancer, recurrence, round ligament
Background The majority of women with ovarian cancer present with advanced stage disease. A complete clinical remission after surgical cytoreduction and platinum-based chemotherapy can be achieved in 80-90% of these patients. Despite this, 70-90% of patients will develop recurrent disease [1]. Fifty-five percent of the first relapse cases were found at the pelvis or abdomen [2]. There was a wide variety among the other recurrent sites, such as, retroperitoneal nodes, liver or spleen, brain, and bone [2,3]. We experienced a case with solitary recurrence at the left round ligament. To the best of our knowledge, this is the first report of recurrent ovarian cancer occurring in the round ligament. Case A 44-year-old woman presented with a 1.5-year history of progressive enlargement of a lower abdominal mass. On physical examination, a pelvic mass was noted. Transvaginal ultrasound revealed bilateral adnexal masses (left: 80*58 mm, right: 54*40 mm) with solid * Correspondence: [email protected] Division of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuoku, Tokyo 104-0045, Japan
components in the pelvic cavity. Computed tomography (CT) (Figure 1) and magnetic resonance imaging (MRI) showed bilateral adnexal tumors and dissemination extending from the pelvis to the upper abdomen. There was no evidence of lymphadenopathy. A left mammary tumor was incidentally discovered by CT, and fineneedle aspiration of the breast revealed cells consistent with adenocarcinoma. The serum cancer antigen 125 (CA125) level was elevated to 348 U/ml (normal range, < 35 U/ml). She underwent a total abdominal hysterectomy with
Data Loading...
