A rare presentation of high-grade serous ovarian carcinoma with ulcerating inguinal lymph node metastasis: a case report

TL;DR

A rare case of ovarian cancer spreading to an unusual lymph node is reported, highlighting the need for early detection and genetic testing.

Contribution

This case report highlights an atypical presentation of high-grade serous ovarian carcinoma with inguinal lymph node metastasis.

Findings

A premenopausal woman presented with an ulcerating inguinal mass, later confirmed as metastatic HGSOC.

Genetic testing revealed a BRCA1 mutation, guiding adjuvant therapy with Olaparib.

The case underscores the importance of considering ovarian cancer in atypical lymph node masses.

Abstract

High-grade serous ovarian carcinoma (HGSOC) typically spreads within the peritoneal cavity, and metastatic spread to extraperitoneal lymph nodes, particularly the inguinal region, is rare. Herein, we present a case of a 47-year-old premenopausal woman who presented with an enlarging, ulcerating right inguinal mass. Imaging revealed a necrotic inguinal mass, with no significant intra-abdominal findings. Surgical excision was performed, and histopathology confirmed metastatic HGSOC. She then underwent neoadjuvant chemotherapy, followed by radiotherapy. She then underwent robotic-surgical staging. Histopathological analysis showed bilateral ovarian involvement with multiple tumor foci. Genetic testing identified a BRCA1 mutation, leading to adjuvant maintenance therapy with Olaparib. This case emphasizes the importance of considering ovarian carcinoma in the differential diagnosis of unusual inguinal lymph node masses, even without a visible ovarian mass. Early detection, genetic testing, and a multidisciplinary approach are essential for optimizing patient outcomes in advanced HGSOC with atypical metastasis.

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