Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2024; 12(6): 1190-1195
Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1190
Management of retroperitoneal high-grade serous carcinoma of unknown origin: A case report
Wen-Lin Hsieh, Dah-Ching Ding
Wen-Lin Hsieh, Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
Dah-Ching Ding, Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan, Taiwan
Author contributions: Ding DC contributed to conceptualization, methodology, formal analysis, writing-original draft preparation, and writing, review, and editing; Hsieh WL contributed to data curation and wrote the original draft. All the authors have read and agreed to the published version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Dah-Ching Ding, MD, PhD, Director, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, No. 707 Chung-Yang Road, Sec. 3, Hualien 970, Taiwan.
Received: December 18, 2023
Peer-review started: December 18, 2023
First decision: January 10, 2024
Revised: January 15, 2024
Accepted: January 23, 2024
Article in press: January 23, 2024
Published online: February 26, 2024

Retroperitoneal high-grade serous carcinoma (HGSC) of unknown origin is a sporadic tumor that can originate from ovarian cancer. Herein, we report the case of a woman with retroperitoneal HGSC of unknown origin and describe how she was diagnosed and treated.


A 71-year-old female presented with the tumor marker CA125 elevated to 1041.9 U/mL upon a regular health examination. Computed tomography revealed retroperitoneal lymph node enlargement. Subsequently, positron emission tomography scanning revealed lesions with increased F-18 fluorodeoxyglucose uptake at the nodes. As a result, she underwent laparoscopic lymph node resection, and pathology revealed metastatic adenocarcinoma with CK7(+), PAX8(+), WT1(+), PR(-), and p53 mutational loss of expression, indicating that the origin may be from the adnexa. The patient was admitted to our ward and underwent laparoscopic staging; however, the pathological results were negative. Under the suspicion of retroperitoneal HGSC of unknown origin, chemotherapy and targeted therapy were initiated. Tumor marker levels decreased after treatment.


We present a case of HGSC of unknown origin managed using retroperitoneal lymphadenectomy, staging surgery, chemotherapy, and targeted therapy.

Keywords: High-grade serous carcinoma, Retroperitoneum, Origin, Chemotherapy, Lymph node, Case report

Core Tip: We report a case of high-grade serous carcinoma (HGSC) of unknown origin in a postmenopausal woman treated with lymphadenectomy and chemotherapy. We provide updated information regarding the symptoms, signs, diagnosis, treatment, and prognosis of HGSCs of unknown origin. Based on our experience, we report our strategy to diagnose and treat this condition.