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Fallopian tube tumour presenting as supraclavicular lymph node metastasis
Maria Lúcia Moleiro1, Helena Veloso2, Rafael Duarte Brás2
1Departamento da Mulher e da Medicina Reprodutiva, Centro Materno Infantil do Norte Dr Albino Aroso - Centro Hospitalar Universitário do Porto, Porto, Portugal lucia.moleiro@gmail.com.
BMJ Case Reports
|February 25, 2022
Summary
A rare case of high-grade serous carcinoma (HGSC) originating in the fallopian tube (FT) presented initially with a supraclavicular lymph node lump. This presentation is unusual, especially without obvious pelvic disease.
Area of Science:
- Gynecologic Oncology
- Pathology
- Medical Imaging
Background:
- High-grade serous carcinoma (HGSC) is the most common type of ovarian cancer.
- Fallopian tube (FT) cancers are often diagnosed at advanced stages.
Observation:
- A 72-year-old woman presented with a left supraclavicular fossa lump.
- Initial investigations revealed metastatic carcinoma, with lymph node involvement in the retroperitoneum and pelvis.
- Elevated CA125 and CA72.4 tumor markers were noted.
Findings:
- Biopsies confirmed metastatic high-grade serous carcinoma (HGSC).
- Despite extensive lymphadenopathy, gynecological examination and pelvic imaging were unremarkable.
- Diagnostic laparoscopy identified a primary HGSC in the fallopian tube (FT), measuring only 1.5 mm.
Implications:
- This case highlights the unusual presentation of fallopian tube (FT) high-grade serous carcinoma (HGSC) with supraclavicular lymph node metastasis as the initial sign.
- The widespread lymphadenopathy without macroscopic pelvic disease at diagnosis is rare, challenging initial diagnostic pathways.
- This underscores the importance of thorough investigation even with seemingly distant initial findings for gynecologic malignancies.
