SYSTEMIC LYMPHADENOPATHY AS THE PRIMARY SYMPTOM OF SEROUS SURFACE PAPILLARY CARCINOMA OF THE OVARY

Serous surface papillary carcinoma (SSPC) is a distinct type of ovaria n cancer; most of the patients present with extensive intraabdominal d isease at the time of diagnosis, In a 48-year-old patient with 6-month history of inguinal and then scalene lymphadenopathy, although series workup did not disclose any primary tumor, an exploratory laparotomy was performed because of the abnormally high serum CA-125 level (1024 U/ml) and the pathologic examination of the inguinal node suggesting a n ovarian origin. At exploration, there was only a discernible SSPC le sion on the right ovary; no intraperitoneal spread but extensive lymph node metastasis was found. The patient died of disease 30 months afte r surgery, although adjuvant and salvage chemotherapy was given. Ovari an cancer should be part of the differential diagnosis in a woman with systemic lymphadenopathy but without any evidence of intraabdominal d isease. (C) 1995 Academic Press, Inc.