Solitary Round Ligament Metastasis in High-Grade Serous Carcinoma Ovary

Introduction The major pathway of metastasis in Epithelial ovarian cancer is through direct exfoliation of cells in peritoneal cavity. Isolated distant metastasis especially in round ligament is hardly reported. Main Symptoms/Clinical Findings We present a rare case of solitary round ligament metastasis in a 42-year-old woman who self-referred to us after her initial treatment for ovarian cancer. She was diagnosed to have high-grade serous carcinoma ovary stageIIIC for which she underwent 3 cycles of chemotherapy with carboplatin and paclitaxel, interval cytoreductive surgery and 3 cycles ofadjuvant chemotherapy. Main Diagnosis Therapeutic Intervention And Outcome After 6months of completion of treatment, we advised a follow-up imaging with CECT abdomen and pelvis which showed a 1.6 x 1.1 cm enhancing nodule in the right inguinal region. The CA 125 value is 16.3 and her clinical examination was normal. PET-CT showed a metabolically active single lesion of 1.6 x 9 mm nodule in the right inguinal area. Fine-needle aspiration study confirmed poorly differentiated adenocarcinoma. An institutional tumour board decision was taken for resection. The patient underwent right inguinal mass excision and final histopathology suggest ovarian cancer metastasis in round ligament. Conclusion Metastasis in inguinal area mostly denotes lymphnodes but round ligament is rare but possible site in epithelial ovarian cancer.