Retroperitoneal metastatic spread of malignant Brenner tumor

It became evident that ovarian cancer spreads mainly by continuity to the adjacent pelvic organs. Retroperitoneal node metastases, especially in the absence of other forms of spread, when the neoplasm is confined to the ovary, is less well described. Recent literature stressed that different histological types of ovarian epithelial cancer can and do spread to the retroperitoneal lymphatics early in the course of the disease. In this report we present a patient with FIGO Ia malignant Brenner tumor in whom metastatic disease was found in retroperitoneal lymph nodes. To our knowledge, a similar observation has not been previously described. It should be concluded that selective biopsies of the retroperitoneal lymph nodes should be part of the staging laparotomy for any ovarian carcinoma.