Ovarian carcinoma presenting with inguinal metastatic lymphadenopathy 33 months prior to intraabdominal disease

Ovarian carcinoma normally presents at an advanced stage of disease, with symptoms of gastrointestinal disturbances. We report a case of ovarian carcinoma presenting with metastatic inguinal lymphadenopathy which preceded any evidence of intraabdominal disease by 33 months. This is the first report of such a case. It defies the expected presentation and course of ovarian malignancies. The case is all the more rare when the incidence of inguinal node involvement in ovarian cancer is considered. The management of this patient and theoretical explanations are discussed.