What happened, in summary

A 48-year-old woman underwent bilateral oophorectomy for mucinous ovarian carcinoma. Five and a half years later, follow-up imaging showed an enlarging 1.2-cm nodule in the right lung. At six years after her ovarian surgery, she underwent thoracoscopic segmentectomy, and pathology confirmed that the lung nodule was a metastasis from the ovarian cancer.

Almost four years after the lung surgery, her CA19-9 level rose and CT showed a mass next to the prior staple line. PET imaging also showed increased activity, raising concern for a local recurrence. Bronchial cytology did not find malignant cells, and the mass became slightly smaller on a subsequent CT, but the overall findings remained concerning enough that she underwent completion right lower lobectomy.

Pathology from the second lung operation found an epithelial granuloma with no evidence of malignancy. Her CA19-9 level fell after surgery, supporting a benign inflammatory process rather than recurrent ovarian cancer in that lesion.