• Weijing Wang, Xuechao Ji, Hanchao Yang, and Xinbo Wang.
• Department of Obstetrics and Gynecology, Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, China.
• Medicine (Baltimore). 2024 Oct 25; 103 (43): e40202e40202.

RationaleOvarian carcinosarcoma (OCS) is a rare malignant tumor prone to distant metastasis. Primary manifestations include pelvic and/or abdominal pain, bloating, and compression. Nevertheless, it is uncommon for OCS to present primarily with persistent fever. This is the first reported case of OCS with lung metastasis characterized by persistent fever.Patient ConcernsA 61-year-old female patient complaining of abdominal pain and fever was admitted to our hospital. Computed tomography showed an irregular, slightly low-density mass on the left side of the uterus and multiple solid nodules in both lungs.DiagnosesShe underwent cytoreductive surgery for pathologically confirmed stage IVB OCS.InterventionsShe was administered chemotherapy after cytoreductive surgery. Given the patient's history of persistent fever and progressively enlarged pulmonary nodules, a pulmonary abscess was considered as a possible diagnosis. Following antibiotic therapy, the patient's high body temperature did not decrease; however, following nonsteroidal anti-inflammatory drug therapy, it quickly decreased. These symptoms were eventually considered the consequence of neoplastic fever caused by lung metastases.OutcomesOwing to the rapid progression of the disease, the patient ultimately died.LessonsThis study suggests that, for patients with pelvic and/or abdominal pain, bloating, and pelvic masses, especially those with suspicious lesions in other organs accompanied by fever of unknown origin, a diagnosis of cancer or sarcoma with metastasis should be considered after ruling out infectious fever.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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