Ovarian carcinoma in normal size ovaries with inguinal lymph node metastasis: a case report inhibitor-like mechanism

It is generally recognized that ovarian cancer tends to remain intra-abdominal even in advanced stages. This case report describes a patient with ovarian carcinoma who had an ulcerated fungating growth in her left groin area. Case history: A 35yrs para2 women presented with a fungating left inguinal node of 5 x 4 cm for last 3 months. Biopsy revealed metastatic papillary adenocarcinoma. Clinical examination showed left sided pedal oedema. Laboratory investigation revealed increased CA125 (412IU/ml).Radiological studies were normal. In view of the raised Ca 125 she was treated in the lines of FIGO stage III cancer ovary with Paclitaxel 260mg and Carboplatin 450mg for three cycles. She responded dramatically with completely healedinguinal nodes. Then laparotomy with total hysterectomy, bilateral salpingo-oophorectomy partial omentectomy and inguinal lymph node dissection were performed. Histology confirmed right ovarian adenocarcinoma consistentwith the earlier histology of the left inguinal lymph node. There were noother sites of involvement. Postoperatively, the patient received three more cycle of chemotherapy. Conclusions: Ovarian cancer with inguinal lymph node metastasis is uncommon and only around 1% of ovarian carcinoma have a normal sized ovary. This case report demonstrates that early distal metastasis, although rare, can occur in patients with ovarian cancer and may be a compelling symptom of ovarian cancer.