Arch Gynecol Obstet (2009) 279:203–207 DOI 10.1007/s00404-008-0669-5 123 CASE REPORT Axillary lymph node metastasis from serous ovarian cancer: a case report and review of the literature Çetin Aydin · Haluk R. Ünalp · Ali Baloflu · Ayoe Gül Ãnci · Seyran Yifit · Ali Yavuzcan Received: 18 February 2008 / Accepted: 21 April 2008 / Published online: 10 May 2008  Springer-Verlag 2008 Abstract Introduction The symptoms and Wndings of ovarian can- cer are parallel with the degree of intra-abdominal expan- sion of the tumor. Metastases in the early stage occur by peritoneal Xuid’s tracking via the circulatory system. Renal and cerebral metastases of ovarian cancer have been previ- ously reported, but axillary lymph node metastasis is quite rare. Axillary lymph node metastasis usually occurs in the advanced stage. Materials and methods We present a 47-year-old female who had applied adjuvant chemotherapy following cyto- reductive surgery because of stage 3C ovarian cancer. Axillary lymph node metastasis was detected in the postoperative 32 months. Conclusion As tumors in axillary lymph nodes are found in patients with an ovarian carcinoma, the treatment is also so important too. Metastasis to the breast be diVerentiated accurately from primary breast cancer, because prognosis and treatment diVer signiWcantly. Accurate diagnosis of these metastases may allow more appropriate theraphy such as chemotherapy and prevent the patient from an unneces- sary major breast surgery. Keywords Axillary lymph node · Carcinoma of ovary · Metastasis IntroductÂon Dissemination of ovarian cancer is most common by the intra-peritoneal route to the pouch of Douglas, paracolic spaces, capsule of liver, serosal surface of bowel wall, mes- entery and omentum so that in the majority of patients, dis- ease most frequently remains conWned to the peritoneal cavity. However, metastasis of ovarian cancer to the retro- peritoneal organs such as kidney or distant organ metasta- ses such as brain have also been previously reported but very few papers describe extra-abdominal lymph node involvement in this type of tumor [1, 2]. Extra-abdominal lymph node metastases can be explained on an anatomic basis. Supradiaphragmatic lymph node metastases without involvement of para-aortic lymph nodes are less easy to explain. This seeming ability to “skip” lymph nodes sup- ports the feasibility that serous carcinoma could follow the central lymphatic duct and present in a supradiaphragmatic lymph node without involvement of the retroperitoneal lymph nodes [3]. An isolated axillary lymph node metasta- sis mass is extremely rare [4]. We present a 47-year-old patient with ovarian cancer in whom an isolated axillary Ç. Aydin · A. Baloflu · A. G. Ãnci · A. Yavuzcan (&) Gynecology and Obstetric Clinic, Ataturk Training and Research Hospital, 35820 Izmir, Turkey e-mail: draliyavuzcan@yahoo.com Ç. Aydin e-mail: cetinaydin2005@mynet.com A. Baloflu e-mail: abaloglu@yahoo.com A. G. Ãnci e-mail: aysegulincidr@hotmail.com H. R. Ünalp Surgery Clinic, Ataturk Training and Research Hospital, Izmir, Turkey e-mail: drhru@mynet.com S. Yifit Pathology Department, Ataturk Training and Research Hospital, Izmir, Turkey e-mail: seyranyigit@hotmail.com