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以孤立性腋窝淋巴结转移为表现的复发性卵巢癌：一例罕见病例报告。

Recurrent ovarian cancer presenting with isolated axillary lymph node metastasis: A rare case report.

作者信息

Phung Huyen Thi, Nguyen Anh Quang, Van Nguyen Tung, Nguyen Long Thanh

机构信息

Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Viet Nam.

Department of Oncology, Vietnam University of Traditional Medicine, Hanoi, Viet Nam.

出版信息

Ann Med Surg (Lond). 2022 Apr 20;77:103640. doi: 10.1016/j.amsu.2022.103640. eCollection 2022 May.

DOI:10.1016/j.amsu.2022.103640
PMID:35638064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9142611/
Abstract

INTRODUCTION

Ovarian cancer with metastatic axillary lymph node is a very rare entity. This study aims to report a case of recurrent ovarian cancer presenting with isolated axillary lymph node metastasis.

CASE PRESENTATION

We report a case of a 58-year-old patient with recurrent ovarian cancer in the axillary node and a suspected lesion in the ipsilateral breast. One year before recurrence, the patient was diagnosed with FIGO stage IIIC ovarian cancer and was treated with primary debulking and paclitaxel-carboplatin adjuvant chemotherapy. Biopsies of the breast lesion, right and left axillary lymph node yielded a fibroadenoma in the breast and a metastatic carcinoma in the axillary node. Immunohistochemistry stains of the left axillary node biopsy specimen was positive for CK7, P53 and PAX-8 markers, and negative for CK20 and GCDFP-15 markers. Immunohistochemistry results combined with a history of ovarian cancer helped confirm the ovarian origin of axillary lymph node metastasis.

CLINICAL DISCUSSION

Recurrent ovarian cancer presenting with isolated axillary lymph node metastasis is rare. Immunohistochemistry combined with medical history is essential for definitive diagnosis in this situation. PAX-8 and GCDFP-15 help to differentiate the origin from the breast or the ovary.

CONCLUSION

Oncologists and pathologists should recognize this rare clinical scenario for early diagnosis and treatment. Detailed medical history, imaging, and immunohistochemical studies on biopsy specimen should help reach accurate diagnosis.

摘要

引言

伴有腋窝淋巴结转移的卵巢癌是一种非常罕见的疾病。本研究旨在报告一例以孤立性腋窝淋巴结转移为表现的复发性卵巢癌病例。

病例介绍

我们报告一例58岁患者，其腋窝淋巴结出现复发性卵巢癌，同侧乳房有可疑病变。复发前一年，该患者被诊断为国际妇产科联盟（FIGO）IIIC期卵巢癌，并接受了初次肿瘤细胞减灭术及紫杉醇 - 卡铂辅助化疗。对乳房病变、左右腋窝淋巴结进行活检，结果显示乳房为纤维腺瘤，腋窝淋巴结为转移性癌。左腋窝淋巴结活检标本的免疫组化染色显示，细胞角蛋白7（CK7）、P53和配对盒基因8（PAX - 8）标记物呈阳性，细胞角蛋白20（CK20）和乳腺珠蛋白（GCDFP - 15）标记物呈阴性。免疫组化结果结合卵巢癌病史有助于确认腋窝淋巴结转移的卵巢来源。

临床讨论

以孤立性腋窝淋巴结转移为表现的复发性卵巢癌很罕见。在这种情况下，免疫组化结合病史对于明确诊断至关重要。PAX - 8和GCDFP - 15有助于区分肿瘤起源于乳房还是卵巢。

结论

肿瘤学家和病理学家应认识到这种罕见的临床情况以便早期诊断和治疗。详细的病史、影像学检查以及对活检标本的免疫组化研究应有助于做出准确诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/4da911a1e4a8/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/6bd73fb4d55e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/6a5e3bb10bbe/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/d6c211016737/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/4da911a1e4a8/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/6bd73fb4d55e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/6a5e3bb10bbe/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/d6c211016737/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e3/9142611/4da911a1e4a8/gr4.jpg

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