A case of tubal cancer with lymphadenopathy in a supraclavicular node as a diagnostic clue

Abstract

A 45-year-old nulligravida visited a local clinic with the complaint of cervical tumor. She was referred to the department of internal medicine at our hospital because of lymphadenopathy in a supraclavicular node. Positron emission tomography-computed tomography showed abnormal signals in multiple lymph nodes from the neck to the pelvic cavity, indicating multiple metastases; however, no origin of disease was detected. Pathological examination by lymph node biopsy showed serous carcinoma, and immunohistochemical staining suggested gynecological cancers. The patient was referred to our department for the examination of gynecological cancers. No abnormal findings were detected on pelvic examination. Uterine cervical cytology showed adenocarcinoma, with origin in the uterine corpus or ovary. Enhanced magnetic resonance imaging showed a tube-like lesion behind the left ovary, which suggested tubal swelling. Laparoscopic examination showed left tubal swelling without left ovarian swelling or peritoneal dissemination. Left salpingo-oophorectomy was performed. Cytology-positive ascites was observed. Pathological examination findings indicated high-grade serous carcinoma in the left tube, but not in the left ovary. The clinical diagnosis was tubal cancer stage IVB. [Adv Obstet Gynecol, 69 (2) : 93-99, 2017 (H29.5)]