{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:08:16Z","timestamp":1753862896089,"version":"3.41.2"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Cardiophrenic metastasis is typically a late stage manifestation of ovarian high grade serous carcinoma. Here we present a case where this was the sole presentation of this disease. This case challenges our current understanding of the natural course of ovarian high grade serous carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Ovarian cancer is typically described to spread from its primary site within the fallopian tubes or ovaries into the peritoneal cavity and beyond with cardiophrenic lymph node involvement being considered a late stage disease process. Here we present the case of a lady in her 60s where increased metabolic activity of the cardiophrenic lymph node was picked up in the investigation of an adenocarcinoma of the lung. Post\u2010thoracoscopic resection histopathological analysis of this lymph node showing an epithelial structure with positive immunohistochemical markers PAX8, WT1, ER, and p16 with a p53 wild type\u2010pattern were the sole presenting features of a high grade serous ovarian carcinoma, that was otherwise undetectable by radiological or hematological screening. Only histopathological analysis after modified radical hysterectomy in gynae\u2010oncological fashion were able to identify a 4\u2009mm lesion within the left fallopian tube. This case questions our current understanding of the natural history of ovarian carcinomas.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9418","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T09:52:26Z","timestamp":1725357146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiophrenic lymph node metastasis as the sole presentation of high grade serous ovarian carcinoma"],"prefix":"10.1002","volume":"12","author":[{"given":"Thomas Julius","family":"Henning","sequence":"first","affiliation":[{"name":"Medical Science Division University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Zouridis","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Churchill Hospital Oxford University Hospitals Trust  Oxford 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