Video-assisted thoracoscopic surgery for recurrent ovarian cancer with a metastatic mediastinal mass.

Background: Although primary cytoreductive surgery is well accepted as a cornerstone of the management for epithelial ovarian cancer, the benefits of secondary cytoreduction in recurrent ovarian cancer remain unclear. Furthermore, no consensus has been reached regarding treatment strategies for extraperitoneal metastasis.

Methods: A 29-year-old woman was admitted to our hospital due to suspected recurrent ovarian cancer. Four years previously, she had undergone primary debulking surgery which was followed by adjuvant chemotherapy consisting of paclitaxel (175 mg/m(2)) and carboplatin (area under the curve = 5) for 6 cycles due to an ovarian papillary serous adenocarcinoma stage IIIc. Preoperative evaluation revealed a palpable inguinal mass and multiple enlarged pelvic lymph nodes with a well-defined mediastinal mass on abdomino-pelvic and chest computed tomography. Secondary debulking combined with video-assisted thoracoscopic surgery (VATS) was performed. The patient had no discernable evidence of disease at her 18-month follow-up.

Conclusions: VATS may be a reasonable option for secondary debulking in selected patients with isolated mediastinal metastasis.