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Presence of Talc in Pelvic Lymph Nodes of a Woman With Ovarian Cancer and Long-Term Genital Exposure to Cosmetic Talc

Cramer, Daniel W. MD, ScD1; Welch, William R. MD2; Berkowitz, Ross S. MD3; Godleski, John J. MD4

doi: 10.1097/01.AOG.0000262902.80861.a0
Case Reports

BACKGROUND: Although epidemiologic studies suggest talc use may increase ovarian cancer risk, there is no proof that talc used externally reaches the pelvis.

CASE: A 68-year-old woman with stage III ovarian papillary serous carcinoma revealed she had used talc daily for 30 years to powder her genital area. Examination of her pelvic lymph nodes under polarized light microscopy showed diffuse areas of birefringence compatible with talc, confirmed by scanning electron microscopy and X-ray spectroscopy.

CONCLUSION: This description of talc in pelvic lymph nodes of a woman with ovarian cancer and decades of exposure to talc may prompt new studies and offer new insights into the biologic basis for the consistent, but debated, association between talc use and ovarian cancer.

Polarized light and scanning electron microscopy identified talc in the pelvic lymph nodes of a woman with ovarian cancer and long-term cosmetic talc use.

From the 1Obstetrics and Gynecology Epidemiology Center, 2Women's and Perinatal Division, Department of Pathology, and 3Division of Gynecology Oncology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School; and 4Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.

Supported by R01CA054419, Genes, Hormones & Environment in an Ovarian Cancer Model from the National Cancer Institute and 1P50CA105009, Ovarian SPORE, from the National Cancer Institute.

The authors thank Ms. Rebecca Stearns for the scanning electron microscopy and energy dispersive X-ray spectroscopy studies.

Corresponding author: Daniel W. Cramer, MD, ScD, Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, 221 Longwood Ave, Boston MA 02115; e-mail: dcramer@partners.org.

Financial Disclosure The authors have no potential conflicts of interest to disclose.

© 2007 The American College of Obstetricians and Gynecologists