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Ovarian Cancer Metastasis to Lung Parenchyma without Peritoneal Dissemination: A Rare Case

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Shwetal Sonvane, Naveen Kumar Gupta, Jyoutishman Saikia, Ruchi Rathore, Sagir Akhtar, Mukurdipi Ray


Ovarian cancer is the most lethal gynecological malignancy worldwide. Despite the advances in treatment for ovary cancer, the 5-year survival rate of advanced ovarian cancer patients with peritoneal metastasis remains as high as 30%. Clinical stage is the most important prognostic factor and most patients are at an advanced stage. There is often no clearly identifiable precursor lesion; therefore, the events which lead to metastatic disease are poorly understood. Solitary lung parenchyma metastasis is extremely rare. We report a case of 39-year-old woman who was admitted with a lung mass. She had a history of high-grade serous carcinoma ovary, which was detected and treated 6 years ago with cytoreductive surgery as well ashyperthermic intraperitoneal and adjuvant chemotherapy. During the routine follow-up, positron emission tomography computed tomography scan showed two nodules of soft-tissue density in the lung parenchyma of the left lower lobe with a dimension of 2.8 × 2.5 cm. Intraoperatively, two conglomerated lung nodules seen in lung parenchyma of the left lower lobe. Deeper nodule was in close proximity to the left lower lobe bronchus and left lower lobe pulmonary artery. Video-assisted thoracoscopic surgery was conducted to perform left lower lobectomy. Postoperatively, the patient was stable. Microscopically, the tumor was classified as a high-grade serous carcinoma, and the patient was diagnosed for having an ovarian cancer metastasis. Ovarian cancer rarely metastasizes to the lung parenchyma in a relapse. However, excision of lesion with further chemotherapy showed excellent results. Surgical excision biopsy and intraoperative frozen sectioning, followed by lobectomy or segmentectomy, are both diagnostic and therapeutic. 


Ovarian carcinoma; Lung parenchyma metastasis; Lobectomy

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