Supradiaphragmatic manifestations of papillary serous adenocarcinoma of the ovary

AIM: To illustrate unusual patterns of isolated supradiaphragmatic presenta tion and relapse of papillary serous adenocarcinoma of the every. METHODS: Retrospective study of five women (26-57 years) managed by a speci alist gynaecological oncology unit. RESULTS: Three nomen relapsed in the neck, mediastinal or axillary nodes 3 to 5 years after complete abdomino-pelvic remission, Tno women presented wi th pleural or cervical lymph node metastases respectively 2 and 13 years be fore the primary pelvic tumour was discovered, Clinical presentations in th ese five women mimicked metastatic thyroid and breast cancer and mesothelio ma, In four of the five woman supradiaphragmatic nodal disease was heavily calcified. CONCLUSION: Women with papillary serous ovarian cancer may develop supradia phragmatic disease without evidence of peritoneal metastasis or primary pel vic tumours, Isolated supradiaphragmatic relapse may occur many years after complete remission of abdomino-pelvic disease, Calcification in supradiaph ragmatic lymph nodes should not be assumed to be due to old granulomatous d isease as this may be the only clue to relapsing disease, Review of prior h istology and use of immunohistochemical stains were valuable in diagnosis o f these cases, Patel, S. V. et al. (1999). Clinical Radiology 54, 748-754. (C) 1999 The Royal College of Radiologists.