Low-Grade Serous Carcinoma in Association With Endosalpingiosis in a Cervical Lymph Node: A Case Report and Literature Review.
Nyein Nyein Htun, Nour Sneige
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Case in brief
A 41-year-old woman with Horner syndrome had a densely calcified, hypermetabolic supraclavicular lymph node and a remote history of serous borderline tumor with noninvasive implants. Fine-needle aspiration and core biopsy showed tubal-type epithelium consistent with endosalpingiosis beside a micropapillary and cribriform neoplastic proliferation with psammoma bodies. PAX-8, estrogen receptor, and WT1 staining supported Müllerian origin. PET-CT showed no recurrent pelvic disease. Neck dissection confirmed low-grade serous carcinoma arising in association with nodal endosalpingiosis.
What made this case unusual
The carcinoma arose in a cervical lymph node alongside benign endosalpingiosis, an unusual setting for malignant transformation; imaging showed dense calcification and hypermetabolism.
Diagnostic / clinical pearl
In a cervical node, tubal-type epithelium adjacent to a Müllerian-pattern neoplasm should prompt consideration of endosalpingiosis-associated low-grade serous carcinoma, rather than assuming a conventional metastatic carcinoma.