Metastatic involvement of inguinal lymph nodes as the first sign of endometroid carcinoma of the fallopian tube

Authors: E. Maradová 1;  M. Janošík 2;  R. Pilka 2 ;  R. Marek 2
Authors‘ workplace: Porodnicko-gynekologické oddělení, Nemocnice Šumperk a. s. 1;  Porodnicko-gynekologická klinika LF UP a FN Olomouc 2
Published in: Ceska Gynekol 2022; 87(5): 328-332
Category: Case Report


Manifestation of ovarian carcinoma in the form of inguinal lymph node involvement represents a rare clinical situation described only by a limited number of case reports. Similarly, extraperitoneal dissemination of the tumor in the absence of advanced abdominal disease is uncommon. We report a 58-year-old female patient with a positive family history of ovarian cancer referred for lymph node enlargement in the left groin and elevation of CA 125. An ultrasound examination of the patient’s left groin revealed an enlarged lymph node of a size 4 × 3 cm, the bio­psy of which confirmed a metastatic adenocarcinoma with origin in the female genital area (müllerian epithelium). The finding was suggestive of high-grade endometroid carcinoma. The patient subsequently underwent a PET/CT, with lesions suspect for the presence of viable malignant tissue in the left ovary (which was of normal size) and a lymph node conglomeration in the left groin. The patient was indicated for a radical cytoreductive surgery resulting in no macroscopic residual disease. Definitive histological examination confirmed high-grade endometroid adenocarcinoma of the left fallopian tube of histopathological stage FIGO IVB pT2b pN0 (17/0) pM1 (inguinal lymph node). The patient was dia­gnosed with somatic BRCA1 mutation. The patient was indicated for adjuvant chemotherapy with paclitaxel/carboplatin, 16 cycles were administered, and for subsequent maintenance therapy with PARP inhibitor. Currently, one year after the primary cytoreductive procedure, the patient is in complete remission of the disease.


fallopian tube cancer – lymphatic spread – inguinal lymph node metastases


1. Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008: Cancer incidence and mortality worldwide. 2010 [online]. Available from: https: //

2. Cancer statistics Center, American Cancer Society. 2022 [online]. Available from: cancerstatisticscenter.otg.

3. ÚZIS ČR. Národní onkologický registr 2018. 2022 [online]. Available from: https: //

4. Fischerová D, Zikán M. Diferenciální dia­gnostika benigních a maligních ovariálních nádorů. Moderní gynekologie a porodnictví 2018; 25 (2): 143–149.

5. Zikán M. Karcinom ovária. Moderní gynekologie a porodnictví 2018; 25 (2): 137–142.

6. Scholz HS, Lax S, Tamussino KF et al. Inguinal lymph node metastasis as the only manifestation of lymphatic spread in ovarian cancer: a case report. Gynecol Oncol 1999; 75 (3): 517–518. doi: 10.1006/gyno.1999.5592.

7. Deka P, Shrivastava S, Barmon D et al. Ovarian carcinoma in normal size ovaries with inguinal lymph node metastasis: a case report. J Cancer Ther Res 2013; 2: 3. doi: 10.7243/2049-7962-2-3.

8. Rose PG, Piver MS, Tsukada Y et al. Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. Cancer 1989; 64 (7): 1508–1513. doi: 10.1002/1097-0142 (19891001) 64: 7<1508:: aid-cncr2820640725>; 2-v.

9. Manci N, Bellati F, Graziano M et al. Ovarian cancer, dia­gnosed with PET, with bilateral inguinal lymphadenopathy as primary presenting sign. Gynecol Oncol 2006; 100 (3): 621–622. doi: 10.1016/j.ygyno.2005.09.026.

10. Tayfun G, Burcin S, Mustafa O et al. Isolated Inguinal lymph node metastasis: presenting in ovarian cancer in an unexpected case of relapse: a case report. Gynecol Oncol 2009; 4: 97–100.

11. Bacalbasa N, Balescu I, Balalau C et al. Normal size ovary carcinoma syndrome with inguinal ovarian cancer lymph node metastases – a case report and literature review. In Vivo 2018; 32 (2): 385–389. doi: 10.21873/invivo.11 250.

12. Feuer GA, Shevchuk M, Calanog A. Normal-sized ovary carcinoma syndrome. Obstet Gynecol 1989; 73 (5 Pt 1): 786–792.

13. Berek JS, Hacker NF. Practical gynecologic. Oncology. 3rd ed. Philadelphia: Lippincott Williams and Wikins 1994: 466–467.

14. McGonigle KF, Dudzinski MR. Endometrioid carcinoma of the ovary presenting with an enlarged inguinal lymph node without evidence of abdominal carcinomatosis. Gynecol Oncol 1992; 45 (2): 225–228. doi: 10.1016/0090-8258 (92) 90291-p.

15. Winter-Roach BA, Tjalma WA, Nordin AJ et al. Inguinal lymph node metastasis: an unusual presentation of fallopian tube carcinoma. Gynecol Oncol 2001; 81 (2): 324–325. doi: 10.1006/ gyno.2001.6141.

16. Eser S, Gulhan I, Özdemir R et al. Synchronous primary cancers of the female reproductive tract in Turkish women. Asian Pac J Cancer Prev 2011; 12 (4): 857–859.

17. Ayhan A, Yalcin OT, Tuncer ZS et al. Synchronous primary malignancies of the female genital tract. Eur J Obstet Gynecol Reprod Biol 1992; 45 (1): 63–66. doi: 10.1016/0028-2243 (92) 90195-5.

18. Tong SY, Lee YS, Park JS et al. Clinical analysis of synchronous primary neoplasms of the female reproductive tract. Eur J Obstet Gynecol Reprod Biol 2008; 136 (1): 78–82. doi: 10.1016/j.ejogrb.2006.09.010.

19. Singh N. Synchronous tumours of the female genital tract. Histopathology 2010; 56 (3): 277–285. doi: 10.1111/j.1365-2559.2009.03367.x.

20. Park TW, Felix JC, Wright TC Jr. X chromosome inactivation and microsatellite instability in early and advanced bilateral ovarian carcinomas. Cancer Res 1995; 55 (21): 4793–4796.

21. Micci F, Haugom I, Ahlquist T et al. Tumor spreading to the contralateral ovary in bilateral ovarian carcinoma is a late event in clonal evolution. J Oncol 2010; 2010: 646340. doi: 10.1155/2010/646340.

22. Yin X, Jing Y, Cai MC et al. Clonality, heterogeneity, and evolution of synchronous bilateral ovarian cancer. Cancer Res 2017; 77 (23): 6551–6561. doi: 10.1158/0008-5472.CAN-17-1461.

23. Fujimori M, Takahashi T, Furukawa Y et al. Synchronous bilateral primary ovarian cancer with right endometroid carcinoma and left high-grade serous carcinoma: a case report and literature review. BMC Womens Health 2022; 22 (1): 103. doi: 10.1186/s12905-022-01684-3.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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