Ovarian carcinoma metastatic to bilateral axillary lymph nodes. A case report

Background. Ovarian cancer is a major cause of cancer deaths in women and u sually presents with diffuse abdominal disease. Lymph node metastases are c ommon. but axillary lymph nodes are rarely involved. Case: A 63-year-old woman. initially presenting with abdominal symptoms and massive ascites, underwent optimal cytoreduction followed by intravenous c hemotherapy with paclitaxel and carboplatin. The patient subsequently under went a second-look surgery revealing only microscopically positive disease and then received intraperitoneal chemotherapy with cisplatin. At a followu p visit. she was found to have bilateral axillary lymph node enlargement. M ammography revealed no lesions in either breast. Fine needle aspiration dis section confirmed the diagnosis of metastatic, recurrent ovarian adenocarci noma and subsequently axillary lymph node dissection was undertaken. Conclusion: Ovarian carcinoma, which usually follows typical patterns of me tastatic involvement, can appear in unusual areas.