title: Isolated cardiophrenic angle node metastasis from ovarian primary. report of two cases.
abstract: Ovarian cancer is the most lethal gynaecologic malignancy. It usually spreads out of the abdomen involving thoraco-abdominal organs and serosal surface. This disease is poorly curable and surgery, at early stage, is supposed to achieve the best survival outcome. In systemic dissemination, chemotherapy is indicated, sometimes with neoadjuvant aim. The most common clinical expressions of advanced ovarian carcinoma are multiple adenopathy, neoplastic pleuritis, peritoneal seeding and distant metastasis, mainly hepatic and pulmonary. Isolated adenopathy of the mediastinum is rare and isolated bilateral have never been described before. We report two cases of isolated bilateral cardiophrenic angle lymph node metastasis from ovarian carcinoma, without peritoneal and pleural involvement. Both patients were successfully resected through minimally invasive thoracic surgery. About the role of surgery, few data are available but survival seems to be longer after resection thus, more investigation is required to make the indication to surgery more appropriate in advanced cases.
authors.affiliation: Thoracic Surgery Unit, University of Perugia Medical School, Ospedale S, Maria della Misericordia Perugia, Italy.
authors.forename: Mark
authors.initials: M
authors.lastname: Ragusa
authors.forename: Jacopo
authors.initials: J
authors.lastname: Vannucci
authors.forename: Rosanna
authors.initials: R
authors.lastname: Capozzi
authors.forename: Niccolò
authors.initials: N
authors.lastname: Daddi
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.forename: Francesco
authors.initials: F
authors.lastname: Puma
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D011859:Radiography; D011877:Radionuclide Imaging; D020775:Thoracic Surgery, Video-Assisted