Ovarian cancer presenting as chest wall subcutaneous nodule: A case report and a literature review

Abstract Background. Distant metastasis from primary epithelial ovarian carcinoma is commonly found as nodal and intraperitoneal spread, spread via haematogenous routes or transcoelomic spread. [Rose PG, Piver MS, Tsukada Y, Latus. Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. Cancer 1989;64(7):1508–13; McLaughlin JE, Diebold MD, Rigaud C. Blood borne metastases from an immature teratoma of the ovary in a 36 yr old woman. Histopathology 1989;15(5):546–50] Ovarian cancer presents in different ways, but common presentations include abdominal pain, distention or ascites due to metastatic involvement of peritoneal cavity. Most tumour present at advanced stage and distant metastases to common and uncommon sites are found in patients who have undergone treatment for primary ovarian cancer. [LeRoux PD, Berger MS, Elliott JP, Tamimi HK. Cerebral metastases from ovarian carcinoma. Cancer 1991;67(8):2194–9; Hardy JR, Harvey VJ. Cerebral metastases in patients with ovarian cancer treated with chemotherapy. Gynaecol Oncol 1989;33(3):296–300; Mayer RJ, Berkowitz RS, Griffiths CT. Central nervous system involvement by ovarian carcinoma: a complication of prolonged survival with metastatic disease. Cancer 1978;41(20):776–83] Subcutaneous metastatic nodules from primary ovarian cancer are rarely found in advanced disease [Dapulat J, Hacker NF, Nieberg RK, Berek JS, Rose TP, Sagar S. Distant metastases in epithelial ovarian carcinoma. Cancer 1987;60(7):1561–66]. We describe a case of asymptomatic ovarian carcinoma presenting as a chest wall nodule. Case. An unusual case of primary ovarian carcinoma presenting as asymptomatic chest wall subcutaneous nodules that subsequently were diagnosed as metastatic lesions. Conclusion. An unusual case of ovarian carcinoma where the patient was totally asymptomatic and referred with two tiny subcutaneous nodules. Therefore, lumps of recent onset, although asymptomatic, should either have fine needle aspiration cytology or excision biopsy.