Ovarian carcinoma metastatic to bilateral axillary lymph nodes. A case report.

BACKGROUND: Ovarian cancer is a major cause of cancer deaths in women and usually presents with diffuse abdominal disease. Lymph node metastases are common, but axillary lymph nodes are rarely involved. CASE: A 63-year-old woman, initially presenting with abdominal symptoms and massive ascites, underwent optimal cytoreduction followed by intravenous chemotherapy with paclitaxel and carboplatin. The patient subsequently underwent a second-look surgery revealing only microscopically positive disease and then received intraperitoneal chemotherapy with cisplatin. At a follow-up visit, she was found to have bilateral axillary lymph node enlargement. Mammography revealed no lesions in either breast. Fine needle aspiration dissection confirmed the diagnosis of metastatic, recurrent ovarian adenocarcinoma and subsequently axillary lymph node dissection was undertaken. CONCLUSION: Ovarian carcinoma, which usually follows typical patterns of metastatic involvement, can appear in unusual areas.

A review of factors affecting treatment outcomes: Expected Treatment Outcome Scale.

The Expected Treatment Outcome Scales was developed to gather information on clients who abuse drugs or alcohol, to assess their severity of illness, and to evaluate the effectiveness of drug treatment in nonrandomized clinical studies. The scale is based upon a multiattribute value model reflecting the opinions of an expert panel. The experts identified 25 variables, or predictors of relapse, from which 48 questions were constructed. Answers to the questions are individually scored. These scores are summed to produce an overall Expected Treatment Outcome score. This paper focuses on the development and preliminary validation of the Expected Treatment Outcome Scale. Results of our analysis show a correlation of .89 between the experts' average ratings of hypothetical clients and scores based on our scale. This finding suggests that the Expected Treatment Outcome Scale has face validity and accurately simulates the experts' judgments regarding treatment outcome. Further research is necessary to assess the reliability as well as the concurrent and predictive validity of our instrument.