Skin Metastases from Ovarian Carcinoma · small and isolated radiotherapy has been described as an...
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Remedy Publications LLC., | http://clinicsinoncology.com/ Clinics in Oncology 2019 | Volume 4 | Article 1582 1 Skin Metastases from Ovarian Carcinoma OPEN ACCESS *Correspondence: Alain Lortholary, Centre Catherine de Sienne, Hopital privé du Confluent, 2 rue E Tabarly, 44202 Nantes, France, E-mail: alain.lortholary@ groupeconfluent.fr Received Date: 09 Feb 2019 Accepted Date: 28 Feb 2019 Published Date: 04 Mar 2019 Citation: Castanié H, Chocteau D, Linot B, Gibon E, El Kouri C, Lortholary A. Skin Metastases from Ovarian Carcinoma. Clin Oncol. 2019; 4: 1582. Copyright © 2019 Lortholary A. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Case Report Published: 04 Mar, 2019 Introduction Skin metastases from ovarian carcinoma is a rare entity. About 3% of patients with malignant ovarian carcinoma are reported to have cutaneous metastases. Moreover most of these cases reported have a sister Joseph’s syndrome (periumbilical nodules). We report a case of a 62 years old woman with large cutaneous metastases from ovarian cancer that occurs one year aſter the first line chemotherapy. Case Presentation A 61 years old woman presented with large inguinal node which was present one year before. She finally decides to consult a gynecologist in February 2017. is inguinal node was measured at 6 cm. e scanner showed the voluminous inguinal node and voluminous ovarian tumors Serum Ca 12.5 was 170 U/ml. A coelioscopy was done in March 2017 with salpingo-oophorectomy, peritoneal cytology, ablation of the umbilical nodule and biopsy of the inguinal node. Histology was reported as a serous papillary low grade adenocarcinoma of the ovary stage IVB. She received 6 cycles of chemotherapy: paclitaxel and carboplatin with a partial response. en she had optimal cytoreductive surgery in October 2017: hysterectomy, appendicectomy, omentectomy, inguinal and lombo-aortic lymph node dissection. It remains on histology the same low grade ovary adenocarcinoma on all the lymph nodes resected. In December 2018 the right inguinal lymph node reappeared with also large abdominal cutaneous lesions (Figure 1). ese inflammatory skin lesions appeared rapidly. Histology was reported at this time as a high grade sero papillary adenocarcinoma on the lymph node and the skin lesions. e computed tomography showed no other lesions than inguinal lymph nodes and cutaneous lesions. A new chemotherapy and a testing BRCA mutation are programmed. Discussion Skin metastasis is a rare event in ovarian cancer ranged from 0.9% to 4% [1-3]. Mostly cutaneous metastases happened in breast cancer, lung cancer and kidney cancer [4]. In ovarian cancer, Otsukrand et al. [1] proposed a classification as umbilical metastases (Sister Joseph nodule) and nonumbilical metastases. ey excluded skin metastases at abdominal incision scars or at paracentesis site. ese last patients have a better prognosis [1]. e median survival of the others has been shown is poor: 4 months [5]. is median survival could be today much better with platin taxane chemotherapy and bevacizumab [1,6]. Sometimes when the skin lesions are small and isolated radiotherapy has been described as an option [7]. Our patient has developed Abstract Skin metastases from malignant ovarian carcinoma are very uncommon. ese ovarian cutaneous metastases must be classified as umbilical metastases (Sister Joseph nodule) and nonumbilical metastases. Skin lesions at abdominal incision scars or at paracentesis site are to be considered as a propagation malignant tumor cells and not as metastases. We reported a 62 year old woman with large skin metastases from high grade serous papillary adenocarcinoma of the ovary, initially diagnosed as a low grade carcinoma. is case is uncommon with large skin metastases and transformation of a low grade to a high grade ovarian carcinoma. Castanié H 1 , Chocteau D 1 , Linot B 1 , Gibon E 2 , El Kouri C 1 and Lortholary A 1 * 1 Centre Catherine de Sienne, Hopital privé du Confluent, France 2 Jules Verne Clinic, 2 route de Paris, 44000 NANTES, France
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Remedy Publications LLC., | http://clinicsinoncology.com/
Clinics in Oncology
2019 | Volume 4 | Article 15821
Skin Metastases from Ovarian Carcinoma
OPEN ACCESS
*Correspondence:Alain Lortholary, Centre Catherine de Sienne, Hopital privé du Confluent, 2 rue E Tabarly, 44202 Nantes, France,
E-mail: [email protected]
Received Date: 09 Feb 2019Accepted Date: 28 Feb 2019Published Date: 04 Mar 2019
Citation: Castanié H, Chocteau D, Linot B,
Gibon E, El Kouri C, Lortholary A. Skin Metastases from Ovarian Carcinoma.
Clin Oncol. 2019; 4: 1582.
Copyright © 2019 Lortholary A. This is an open access article distributed under
the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work
is properly cited.
Case ReportPublished: 04 Mar, 2019
IntroductionSkin metastases from ovarian carcinoma is a rare entity. About 3% of patients with malignant
ovarian carcinoma are reported to have cutaneous metastases. Moreover most of these cases reported have a sister Joseph’s syndrome (periumbilical nodules).
We report a case of a 62 years old woman with large cutaneous metastases from ovarian cancer that occurs one year after the first line chemotherapy.
Case PresentationA 61 years old woman presented with large inguinal node which was present one year before.
She finally decides to consult a gynecologist in February 2017. This inguinal node was measured at 6 cm.
The scanner showed the voluminous inguinal node and voluminous ovarian tumors Serum Ca 12.5 was 170 U/ml.
A coelioscopy was done in March 2017 with salpingo-oophorectomy, peritoneal cytology, ablation of the umbilical nodule and biopsy of the inguinal node. Histology was reported as a serous papillary low grade adenocarcinoma of the ovary stage IVB. She received 6 cycles of chemotherapy: paclitaxel and carboplatin with a partial response. Then she had optimal cytoreductive surgery in October 2017: hysterectomy, appendicectomy, omentectomy, inguinal and lombo-aortic lymph node dissection. It remains on histology the same low grade ovary adenocarcinoma on all the lymph nodes resected.
In December 2018 the right inguinal lymph node reappeared with also large abdominal cutaneous lesions (Figure 1). These inflammatory skin lesions appeared rapidly. Histology was reported at this time as a high grade sero papillary adenocarcinoma on the lymph node and the skin lesions. The computed tomography showed no other lesions than inguinal lymph nodes and cutaneous lesions. A new chemotherapy and a testing BRCA mutation are programmed.
DiscussionSkin metastasis is a rare event in ovarian cancer ranged from 0.9% to 4% [1-3]. Mostly
cutaneous metastases happened in breast cancer, lung cancer and kidney cancer [4]. In ovarian cancer, Otsukrand et al. [1] proposed a classification as umbilical metastases (Sister Joseph nodule) and nonumbilical metastases. They excluded skin metastases at abdominal incision scars or at paracentesis site. These last patients have a better prognosis [1]. The median survival of the others has been shown is poor: 4 months [5]. This median survival could be today much better with platin taxane chemotherapy and bevacizumab [1,6]. Sometimes when the skin lesions are small and isolated radiotherapy has been described as an option [7]. Our patient has developed
AbstractSkin metastases from malignant ovarian carcinoma are very uncommon. These ovarian cutaneous metastases must be classified as umbilical metastases (Sister Joseph nodule) and nonumbilical metastases. Skin lesions at abdominal incision scars or at paracentesis site are to be considered as a propagation malignant tumor cells and not as metastases.
We reported a 62 year old woman with large skin metastases from high grade serous papillary adenocarcinoma of the ovary, initially diagnosed as a low grade carcinoma.
This case is uncommon with large skin metastases and transformation of a low grade to a high grade ovarian carcinoma.
Castanié H1, Chocteau D1, Linot B1, Gibon E2, El Kouri C1 and Lortholary A1*1Centre Catherine de Sienne, Hopital privé du Confluent, France
2Jules Verne Clinic, 2 route de Paris, 44000 NANTES, France
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Lortholary A, et al., Clinics in Oncology - General Oncology
Remedy Publications LLC., | http://clinicsinoncology.com/ 2019 | Volume 4 | Article 15822
non umbilical diffuse skin metastases. Nevertheless one year before she had umbilical nodule without umbilical symptoms. Skin ovarian metastases generally indicated a poor prognosis. In our patient, the long interval between the last chemotherapy and the cutaneous involvement seems to be a better prognostic factor. Some patients responded well to the palliative treatment [6]. This case is uncommon with large skin metastases and transformation of a low grade to a high grade ovarian carcinoma.
Figure 1: Diffuse skin metastases: high grade sero papillary adenocarcinoma.
References1. Otsuka I, Matsuura T. Skin metastases in epithelial ovarian and fallopian
tube carcinoma. Medecine. 2017;96:1-8.
2. Dauplat J, Hacker N, Nieberg R, Berek J, Rose T, Sagae S. Distant metastases in epithelial ovarian carcinoma. Cancer. 1987;60(7):1561-6.
3. McDonald H, Moore M, Meffert J. Cutaneous metastases from adenocarcinoma of the ovary. JAAD Case Rep. 2016;2(5):406-7.
4. Brownstein M, Helwig E. Metastatic tumors of the skin. Cancer. 1972;29(5):1298-307.
5. Cormio G, Capotorto M, Di Vagno G, Cazolla A. Skin metastases in ovarian carcinoma: a report of nine cases and a review of the literature. Gynecol Oncol. 2003;90(3):682-5.
6. Karpate S, Samal S, Jain S. Recurrent ovarian malignancy presenting as cutaneous metastasis. Indian J Dermatol. 2009;54(4):3880-1.
7. Wiechert A, Garett L, Lin G, Goodman A. Management of a skin metastasis in a patient with advanced ovarian cancer. Gynecol Oncol Case Rep. 2012;2(4):124-6.
