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Supra-clavicular lymph node metastatic spread in patients with ovarian cancer disclosed at 18F-FDG-PET/CT: an unusual finding

Abstract

Tumoral dissemination of ovarian cancer most commonly occurs through the intra-peritoneal route; nevertheless, although it is rare, ovarian cancer may also metastasise through the lymphatic channels. Lymphatic diffusion of ovarian cancer usually involves pelvic and retro-peritoneal lymph nodes. Extra-abdominal lymph nodes are rarely involved and their detection may represent a challenge for the oncologist. We describe here two patients studied for ovarian cancer by [18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT): one case during pre-operative staging, the other for restaging after surgery. In both cases PET examination identified extra-abdominal lymph node tumoral spread in the left supra-clavicular space; biopsy led to a final diagnosis of recurrent ovarian cancer. Previous reports in the literature on tumoral spread of ovarian cancer to the supra-clavicular nodes are rare, however this possible site of metastatic involvement has to be kept in mind by oncologists and our data show that the 18F-FDG PET/CT may be useful to disclose this unusual supra-diaphragmatic lymphatic diffusion of metastatic lymphatic ovarian cancer.

Author

S Fanti, C Nanni, P Castellucci, M Farsad, L Rampin, M D Gross, G Mariani and D Rubello

Contact Details

Corresponding address:
Domenico Rubello, MD,
Nuclear Medicine Service -- PET Unit,
S Maria della Misericordia Hospital,
Istituto Oncologico Veneto (IOV),
Viale Tre Martiri, 140,
45100, Rovigo, Italy

Reference

ICIS Cancer Imaging Volume 6 Issue 1
DOI: 10.1102/1470-7330.2006.0005

Date Posted

23 March 2006

Open Access is provided for this article.

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