Metastatic ovarian cancer presenting as multiple hepatic cysts and paraneoplastic manifestation

Abstract

Background: Metastatic ovarian diseases are often found on the peritoneal surfaces including the liver, bowel, bladder, and uterus.  Recent studies showed liver metastases as the most common presentation of stage-IV disease in patients with epithelial ovarian cancer  (EOC). Paraneoplastic syndromes in ovarian cancers may be associated with rheumatologic disorders like polymyositis due to  autoimmune mechanisms.

Case Presentation: We report a case of a 61-year-old postmenopausal woman who presented with a 2-month history of progressive right hypochondrial swelling and pain, with progressive weight loss and weakness of the limbs. Examination  revealed tender hepatomegaly with proximal muscle weakness. Abdominopelvic computed tomography (CT) scan revealed enlarged liver  with multiple cystic lesions and right adnexal mass. CA125 and creatine kinase were elevated and ultrasound scan (USS)-guided  trucut biopsy of both the hepatic and adnexal masses revealed papillary cystadenocarcinoma.

Conclusion: We, therefore, concluded that  the diagnosis in our patient is metastatic ovarian cancer to the liver with paraneoplastic phenomenon of polymyositis.