title: Ovarian cancer presenting as an axillary mass: Case series and literature review.
abstract: OBJECTIVE
  Ovarian cancer is a common cause of death in women worldwide. The purpose of this article was to report a case series and draw physicians' attention to the benefits of histpathologic techniques in determining uncommon metastatic diseases.
  
  
  METHODS
  In this study, we report a case series of axillary involvement of ovarian cancer in 6 patients. The data were collected between 2006 and 2015 by analyzing patient's characteristics, and biochemical and immunohistochemical features. No pathologic lesions were detected in breasts. Specific immunohistochemical methods such as GCDFP-15, CA12-5, WT-1, and PAX-8 supported evidence of metastasis from ovarian cancer to axillary lymph nodes.
  
  
  RESULTS
  Biochemical tests showed increased levels of CA12-5 in all patients. In 5 patients, GCDFP-15 was negative and WT-1 was positive with specific immunohistochemical staining. PAX-8 was positive in 3 of 5 patients.
  
  
  CONCLUSIONS
  Physicians need to be aware that histopathologic and immunohistochemical results can make a significant contribution in determining the true primary tissue of metastatic adenocarcinoma, even in the absence of typical clinical findings.
authors.affiliation: Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Millet Caddesi, 34093 Fatih, Istanbul, Turkey. Electronic address: burakmd@yahoo.com.
authors.forename: B
authors.initials: B
authors.lastname: Ilhan
authors.affiliation: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Kılıç
authors.affiliation: Surgical Oncology Unit, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Karanlik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis; D018394:CA-125 Antigen / Q000032:analysis; D002277:Carcinoma / Q000737:chemistry / Q000175:diagnosis / Q000556:secondary*; D002352:Carrier Proteins / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D026901:Membrane Transport Proteins; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D000072636:PAX8 Transcription Factor / Q000032:analysis; D025721:WT1 Proteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D000072636:PAX8 Transcription Factor; C083325:PAX8 protein, human; C488892:PIP protein, human; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: Axillary; Breast; Lymph node; Ovarian cancer