Ovarian carcinoma presenting with axillary lymph node metastasis: a case report

Ovarian cancer is usually limited to the abdomen and frequently remains confined. The occurrence of extrabdominal mestastases is unusual. In this report we describe a rare case of axillary involvement at initial presentation of ovarian cancer in a 48-year-old woman. The axillary mass was the only clinical abnormality. Cytological and histological findings, performed on axillary lymph nodes, showed the presence of psammoma bodies and specific immunohistochemical tumor markers (OC-125 and WT1), supporting the evidence of a metastatic axillary lymphadenopathy from ovarian cancer. Subsequently, chest and abdominopelvic computed tomography showed a right ovarian complex mass of 30 x 25 mm and biochemical tests showed high levels of CA125. Surgical therapy was performed. Histology confirmed the diagnosis, evidencing a poorly differentiated serous-papillary carcinoma of the right ovary. In conclusion, cytological and histological findings can play a crucial role in suggesting the correct origin of a metastatic adenocarcinoma when the clinical presentation is atypical.     

Posthysterectomy carcinoma of the fallopian tube presenting as vaginal adenocarcinoma: A case report

The clinical and pathological features of a case of adenocarcinoma of the fallopian tube with a unique presentation are described. The 68-year-old patient presented with vaginal bleeding 25 years after a vaginal hysterectomy. Pelvic examination revealed a 0.5-cm nodule of tumor involving the mucosa of the vaginal apex. At laparoscopy, the left fallopian tube was dilated and adherent to the vaginal vault. Pathological examination of the upper vaginectomy and bilateral salpingo-oophorectomy specimen revealed a primary papillary adenocarcinoma of the left fallopian tube that had invaded directly into the mucosa of the vaginal apex. Vaginal involvement, either at the time of presentation or subsequently in the course of the disease, is very rare in patients with carcinoma of the fallopian tube.     

Endocervicosis presenting as a painful vaginal mass: a case report.

A case of endocervicosis presenting as a painful vaginal mass in a 36-year-old woman is reported. No previous similar cases have been found in the literature.     

Endometrial metastasis from signet-ring breast carcinoma: case report

Breast cancer rarely metastasizes to the endometrium. The signet-ring variety of breast cancer is very rare and has been reported to metastasize to the endometrium in only three previous reports. We present a patient with signet-ring breast carcinoma with metastasis to the endometrium. The patient presented with vaginal bleeding and was found to have wide spread metastasis. Endometrial metastasis in patients with signet-ring breast cancer usually denotes a poor prognosis.     

Uterine metastasis from hepatocellular carcinoma: a case report

The extrahepatic spread of hepatocellular carcinoma (HCC) is uncommon. Moreover, metastatic uterine tumor from extragenital primaries is rare. We report a 63-year-old woman with uterine metastasis from HCC. She had undergone transcatheter arterial embolization four times and surgery for HCC from 2-4 years before. This time, she underwent resection of a newborn, head-sized uterine tumor that was proven to be metastasis from HCC. This is the first described case of metastatic uterine tumor originated from HCC.     

Isolated cardiac metastasis of cervical carcinoma presenting as disseminated intravascular coagulopathy. A case report

BACKGROUND: An isolated cardiac metastasis from cervical carcinoma is very rare. This report describes the unusual presentation in a patient diagnosed and successfully treated for stage IB squamous cell carcinoma of the cervix, presenting six months later with disease metastatic to the heart. CASE: A 44-year-old woman presented with hand swelling and bruising. She had undergone successful surgical treatment of a stage IB squamous cell cervical carcinoma six months previously. Computed tomography revealed a large mass in the right ventricle, confirmed by echocardiography. The patient underwent surgery, where the mass was biopsied and debulked under a cardiopulmonary bypass. Frozen section confirmed metastatic squamous cell carcinoma. The patient was discharged with follow-up radiation and chemotherapy. CONCLUSION: All women with myocardial abnormalities and a history of squamous cell carcinoma of the cervix should be suspected of developing a myocardial metastasis until proven otherwise.     

Right ventricular metastasis of endometrial carcinoma: a case report

Although between 5 and 20% of cancer deaths have cardiac metastasis at postmortem examination, pelvic malignancy is a seldom-reported primary source. Endometrial carcinoma rarely results in distant metastasis. A patient is described who presented with a large symptomatic right ventricular metastasis 15 months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for Stage I poorly differentiated adenocarcinoma of the uterine corpus.     

Fallopian tube carcinoma presenting with a brain metastasis

BACKGROUND: Fallopian tube carcinoma is a rare gynecologic cancer. An extensive literature search reveals no previous case report of fallopian tube carcinoma presenting with a brain metastasis. CASE: A 63-year-old woman presented with 3 weeks of progressive left-sided weakness. CT scan of the brain revealed a solitary lesion in the right parietal lobe. The patient underwent a complete resection, followed by whole-brain radiation therapy. Pathologic review demonstrated adenocarcinoma with follicular structures. A directed workup revealed a large right adnexal mass. She underwent resection of a large fallopian tube carcinoma with normal ovaries. She recovered from surgery and is receiving combination chemotherapy. CONCLUSION: This is the first case report of a fallopian tube carcinoma presenting as a brain metastasis.     

Malignant extragastrointestinal stromal tumor presenting as a vaginal mass: report of an unusual case with literature review

The clinical and pathologic features of a malignant extragastrointestinal stromal tumor presenting as a vaginal mass are discussed. A 66-year-old female presented with copious vaginal bleeding and spontaneous passage of tumoral tissue per vagina. Histologic assessment showed a mitotically active spindle cell neoplasm. Immunohistochemical analysis demonstrated the neoplasm to be positive for CD117 (transmembrane tyrosine kinase) and CD34, consistent with a malignant extragastrointestinal stromal tumor. Subsequent clinical examination revealed an 8-cm posterior vaginal wall mass, with probable origin from the rectovaginal septum. This case is unique based on the primacy of presenting gynecologic complaints, and the unusual anatomic location of the lesion. A literature review of the pathologic features of extragastrointestinal stromal tumors and factors predictive of biologic behavior are discussed. Correct tumor diagnosis is emphasized given the effective treatment possible with imatinib for patients with unresectable tumors.     

Cerebellar metastasis from ovarian carcinoma. A case report

This report presents an unusual case of 40-year-old woman with complete locoregional remission of ovarian carcinoma, presented with a single cerebellar metastasis. Surgical excision of the cerebellar lesion, followed by brain irradiation, resulted in complete resolution of her symptoms.     

Metastatic mantle cell lymphoma presenting as a vaginal mass. A case report

BACKGROUND: Vaginal masses are an uncommon finding in well-woman gynecologic examinations. The differential diagnosis includes cysts, leiomyomata, ectopic ureteroceles, infected granuloma, and malignancy. CASE: A 74-year-old woman with a history of mantle cell lymphoma was referred for vaginal prolapse. Examination revealed a vaginal mass, with MRI confirming 3 masses. Fine needle aspiration confirmed metastatic mantle cell lymphoma which later regressed with radiation therapy. CONCLUSION: Although vaginal masses are often rare and incidental findings during routine gynecologic examinations, a comprehensive differential diagnosis is required to avoid delays in treatment. Fine needle aspiration should be included as part of the arsenal of diagnostic tools because of its low cost and the ease with which it can be performed in a clinical setting.     

Splenosis presenting with adnexal mass: a case report

Case report A 21-year-old woman presenting with low abdominal discomfort, dysmenorrhoea and pelvic mass was misdiagnosed as endometriosis. She had post-traumatic splenic rupture and laparotomy history. Results Pelvic splenosis was diagnosed at laparotomy. Pelvic mass was removed and the other implants were left.     

Bone metastasis as a presenting feature of endometrial adenocarcinoma: case report and literature review

A rare case of endometrial adenocarcinoma that presented with symptoms of bone metastasis in the right ischium is described. The patient had no signs or symptoms of gynecological malignancy and the diagnostic work up did not reveal the primary disease. The bone metastasis was treated successfully by radiotherapy, but three years later the patient noted vaginal bleeding, which led to the diagnosis and treatment of the primary endometrial cancer. Another 20 cases of endometrial carcinoma with bone metastasis have been found in literature, but only five of them presented with the feature of bone metastasis. Bone metastasis should be considered in patients with endometrial adenocarcinoma.