Ovarian serous carcinoma presenting with mediastinal lymphadenopathy 20 months before the intraabdominal mass: role of immunohistochemistry.
BACKGROUND
Metastatic involvement of the mediastinal lymph nodes is an extremely uncommon finding in epithelial ovarian cancers.


METHODS
A 63-year-old woman was admitted to hospital for dyspnoea due to an anterior mediastinal mass. The surgical biopsy showed a 6-cm metastatic lymph node with a papillary pattern, scattered psammomas and immunoreactivity for WT1, Cytokeratin 7, EMA and negative for E-cadherin, GCFDP-15, Thyroglobulin, Cytokeratin 20, Cytokeratin 5/6, CEA, Vimentin, Calretinin, TTF1. After 20 months a follow-up CT identified an ovarian mass with the same histological pattern and immunoreactivity of the mediastinal nodule.


RESULTS
Immunohistochemistry, especially WT1, is useful in assessing the ovarian origin of an unusual metastasis particularly if it is the first presentation of the disease.
Zannoni
Gian Franco
GF
Department of Pathology, Faculty of Medicine Agostino Gemelli, Catholic University, 00168 Rome, Italy. gfzannoni@rm.unicatt.it
Vellone
Valerio Gaetano
VG
Distefano
Maria Grazia
MG
Fadda
Guido
G
Scambia
Giovanni
G
D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology