Papillary serous carcinoma of the peritoneum with paraaortic lymph node metastasis despite minimal intraperitoneal involvement: a case report

BACKGROUND; Papillary serous carcinoma of the peritoneum (PSCP) is a tumor that produces widespread intraperitoneal lesions. Unlike serous ovarian adenocarcinoma, many aspects of its mode of progression and biologic characteristics are unclear. CASE: A 46-year-old woman with PSCP had no detectable ascites and minimal intraperitoneal involvement at the time of the diagnosis, but a paraaortic lymph node metastasis was present. Preoperative endometrial cytology was positive (suspicion of adenocarcinoma). The histologic diagnosis was poorly differentiated serous adenocarcinoma. Cytology of the peritoneal washings demonstrated positive findings, similar to those of endometrial cytology. After cytoreductive surgery, including lymph node dissection and platinum-based chemotherapy, the patient achieved long-term survival. CONCLUSION: PSCP can present with an early paraaortic lymph node metastasis. Endometrial cytology can be valuable in the diagnosis.