Patterns of Lymphatic Spread in Ovarian Cancer

Introduction Ovarian cancer remains one of the most frequently encountered gynecologic malignancies, being diagnosed in an important number of cases in advanced stages of the disease. In this situation the only therapeutic option remains maximal cytoreductive surgery. The most commonly seen patterns of spread are represented by the peritoneal, lymphatic and hematogenous route. However, although most cases are diagnosed with pelvic and para-aortic lymph node metastases, in certain cases inguinal lymph node metastases might be seen from the beginning. Material and method We present a series of 21 patients submitted to lymph node dissection for advanced stage ovarian cancer. Results Among these cases 19 patients presented pelvic lymph node metastases, three of the 19 patients with pelvic lymph node metastases associated para-aortic lymph node metastases and other two cases were diagnosed with inguinal lymph node metastases; among these two cases, a single patient associated both pelvic and inguinal lymph node metastases. Conclusions Lymphatic spread is frequently encountered in advanced stage ovarian cancer, the most frequently affected lymph node groups being represented by the pelvic and para-aortic stations. However, in certain cases inguinal lymph node metastases might be seen even in the absence of pelvic lymph node metastases.