Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1190
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.
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.