Posterior iliac crest lymph node metastasis from ovarian cancer 15 years after surgery: a mimicker of primary retroperitoneal tumor

Excerpt

Sir,A 37-year-old woman complained of a 1-year history of right-sided lower back pain and right lower-extremity swelling. She had undergone right oophorectomy, without lymphadenectomy, for low-grade ovarian cancer 15 years previously at an outside institution, but she was lost to follow-up. CT demonstrated a high-density retroperitoneal tumor between the right psoas and iliacus muscles. Dense calcifications were noted within the tumor (Fig. 1a). MR imaging demonstrated the tumor to be isointense on T1-weighted images and highly intense on T2-weighted images (Fig. 1b) relative to the skeletal muscles. Gadolinium-enhanced T1-weighted images showed homogenous contrast enhancement. The radiological differential diagnoses included primary retroperitoneal sarcoma and recurrent ovarian cancer, although 15 years had passed since her previous curative surgery for ovarian cancer.

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