Abstract:

Recurrence of high-grade serous ovarian carcinoma (HGSOC) is usually confined to the peritoneal cavity, with vulvar metastasis being extremely rare. We report a case of HGSOCⅠC who achieved initial remission for over 5 years, and subsequently presented with isolated inguinal lymph node metastasis, followed by multiple vulvar nodules as the primary manifestation of extensive systemic recurrence. Biopsy pathology was consistent with metastatic HGSOC. PET/CT revealed metastases in multiple sites throughout the body, and carbohydrate antigen 125 (CA125) was significantly elevated. Following treatment with a regimen of albumin-bound paclitaxel+carboplatin+bevacizumab, the patient achieved biochemical and clinical remission. However, severe hematological toxicity occurred repeatedly, impacting treatment sustainability. This case suggests that rare vulvar metastasis may serve as a "sentinel" for systemic dissemination of HGSOC, highlighting the importance of comprehensive physical examination during follow-up. For patients experiencing recurrence after multiple lines of therapy, a balance must be sought between efficacy and tolerability, with individualized maintenance and subsequent treatment strategies explored based on molecular characteristics.

Key words: Ovarian neoplasms, Carcinoma, Neoplasm recurrence, local, Neoplasm metastasis, Case reports, High-grade serous ovarian carcinoma