Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report

Introduction: Low-grade serous carcinoma (LGSC) is a rare, indolent subtype of epithelial ovarian cancer that often arises from precursor lesions in the ovary or peritoneum and is associated with MAPK pathway mutations. Unlike high-grade serous carcinoma (HGSC), which typically originates from cells...

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Main Authors: Samantha A. Solaru, Marisa C. Liu, Vincent Lee, Robert E. Bristow
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Gynecologic Oncology Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925000943
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author Samantha A. Solaru
Marisa C. Liu
Vincent Lee
Robert E. Bristow
author_facet Samantha A. Solaru
Marisa C. Liu
Vincent Lee
Robert E. Bristow
author_sort Samantha A. Solaru
collection DOAJ
description Introduction: Low-grade serous carcinoma (LGSC) is a rare, indolent subtype of epithelial ovarian cancer that often arises from precursor lesions in the ovary or peritoneum and is associated with MAPK pathway mutations. Unlike high-grade serous carcinoma (HGSC), which typically originates from cells in the fallopian tube, LGSC shows limited response to chemotherapy. An isolated presentation in an extraperitoneal site, such as an inguinal lymph node, is exceedingly rare. We present a case of primary nodal LGSC arising in the setting of endosalpingiosis. Case: An 80-year-old woman presented with a two-year history of left lower quadrant pain and a newly enlarging left groin mass. Imaging identified a vascular left inguinal mass, and initial biopsy favored HGSC. Staging procedures including hysteroscopy, dilation and curettage, and diagnostic laparoscopy with bilateral salpingo-oophorectomy showed normal pelvic organs with no evidence of malignancy. Chemotherapy was initiated but resulted in only a modest response. Surgical resection of the mass itself revealed LGSC with adjacent endosalpingiosis. With no evidence of primary disease elsewhere, a diagnosis of primary inguinal node LGSC arising from endosalpingiosis was made. Conclusion: This case highlights the diagnostic challenges of isolated LGSC without a detectable primary site. Initial misclassification can lead to suboptimal management. Accurate diagnosis requires thorough surgical and pathological evaluation to ensure appropriate treatment in these rare and atypical presentations.
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spelling doaj-art-4e12f3cae7f34235ab6c34f339c844482025-08-20T03:22:11ZengElsevierGynecologic Oncology Reports2352-57892025-06-015910176910.1016/j.gore.2025.101769Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case reportSamantha A. Solaru0Marisa C. Liu1Vincent Lee2Robert E. Bristow3Department of Obstetrics and Gynecology, University of California, Irvine-Medical Center, 3800 West Chapman Avenue, Suite 3400, Orange, CA 92868, USA; Corresponding author at: University of California Irvine, 3800 West Chapman Ave, Suite 3400, Orange, CA 92868, USA.Department of Gynecologic Oncology, University of California, Irvine-Medical Center, 3800 West Chapman Avenue, Suite 3400, Orange, CA 92868, USADepartment of Pathology, University of California, Irvine-Medical Center, 3800 West Chapman Avenue, Orange, CA 92868, USADepartment of Gynecologic Oncology, University of California, Irvine-Medical Center, 3800 West Chapman Avenue, Suite 3400, Orange, CA 92868, USAIntroduction: Low-grade serous carcinoma (LGSC) is a rare, indolent subtype of epithelial ovarian cancer that often arises from precursor lesions in the ovary or peritoneum and is associated with MAPK pathway mutations. Unlike high-grade serous carcinoma (HGSC), which typically originates from cells in the fallopian tube, LGSC shows limited response to chemotherapy. An isolated presentation in an extraperitoneal site, such as an inguinal lymph node, is exceedingly rare. We present a case of primary nodal LGSC arising in the setting of endosalpingiosis. Case: An 80-year-old woman presented with a two-year history of left lower quadrant pain and a newly enlarging left groin mass. Imaging identified a vascular left inguinal mass, and initial biopsy favored HGSC. Staging procedures including hysteroscopy, dilation and curettage, and diagnostic laparoscopy with bilateral salpingo-oophorectomy showed normal pelvic organs with no evidence of malignancy. Chemotherapy was initiated but resulted in only a modest response. Surgical resection of the mass itself revealed LGSC with adjacent endosalpingiosis. With no evidence of primary disease elsewhere, a diagnosis of primary inguinal node LGSC arising from endosalpingiosis was made. Conclusion: This case highlights the diagnostic challenges of isolated LGSC without a detectable primary site. Initial misclassification can lead to suboptimal management. Accurate diagnosis requires thorough surgical and pathological evaluation to ensure appropriate treatment in these rare and atypical presentations.http://www.sciencedirect.com/science/article/pii/S2352578925000943
spellingShingle Samantha A. Solaru
Marisa C. Liu
Vincent Lee
Robert E. Bristow
Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
Gynecologic Oncology Reports
title Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
title_full Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
title_fullStr Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
title_full_unstemmed Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
title_short Isolated low-grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis: A case report
title_sort isolated low grade serous carcinoma arising in inguinal lymph nodes in the setting of endosalpingiosis a case report
url http://www.sciencedirect.com/science/article/pii/S2352578925000943
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