Background: Ovarian cancer, particularly high-grade serous ovarian cancer (HGSOC), is the most lethal gynecological tumor, with most patients experiencing recurrence within 5 years. Long-term survival in HGSOC patients with advanced stages is exceedingly rare.Case summary: We report a case of advanced HGSOC with exceptional long-term recurrence-free survival following initial treatment. In June 2009, the patient underwent suboptimal cytoreductive surgery for stage IIIC ovarian cancer, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy, and resection of mesenteric and peritoneal lesions. Postoperatively, residual lesions were observed in the mesenteries and para-aortic lymph nodes. Despite unfavorable prognostic factors (advanced stage, aggressive pathology, and incomplete resection), the patient showed remarkable chemosensitivity, remaining recurrence-free for 15 years.Conclusion: The factors influencing long-term survival in HGSOC patients are not yet fully understood. We present this rare case to contribute data for further studies on long-term survival in advanced HGSOC.

Rationale: Angiofibroma of soft tissue (AFST) is a rare benign fibrous tumor recently included in the 2020 WHO classification of soft tissue and bone tumors. Currently, there are limited reports on AFST, and pathologists lack sufficient understanding of its clinical and pathological characteristics. There is scarce literature available on AFST in the cervical region. Patient concerns: We presented a case of a 49-year-old woman who was admitted to our hospital for emergency treatment due to vaginal bleeding and fatigue. Ultrasound revealed a 63 × 27 mm hypoechoic mass extending from the cervical opening to the external opening, with a hemoglobin level of 58.0 g/L on blood routine. Diagnoses: The tissue exhibited a pale-yellow mucinous appearance with distinct tissue boundaries and a fibrous capsule under a microscope. HE staining revealed spindle-shaped fibroblast-like cells with a consistent morphology, thin-walled branching small blood vessels, and dilated blood vessels. Regions with abundant cells and areas with sparse cells were alternately distributed and migrated gradually. Immunohistochemical analysis indicated positive expression of P53, desmin, progesterone receptor, estrogen receptor, epithelial membrane antigen, vimentin, CD68, CD163 in the tumor, but negative expression of P16, S-100, smooth muscle actin, CD117, CD10, STAT-6. CD34 was negative in the tumor cells but positive in the vascular endothelium. The Ki-67 index value was 5%. Pathological examination confirmed a soft tissue angiofibroma of the cervix. Interventions: Emergency hysteroscopic surgery was performed following infusion of 3 units of packed red blood cells. A local excision of the cervical mass was performed. Outcomes: A 1-month follow-up ultrasound showed no abnormal mass in the cervical canal, and there have been no signs of recurrence to date. Lessons: Cervical angiofibroma of soft tissue is a rare tumor with a benign clinical manifestation, minimal local recurrence, and no significant metastatic potential. Treatment primarily involves local resection with a focus on achieving negative surgical margins. By presenting this case, we aim to enhance the diagnostic and differential diagnostic capabilities of pathologists in identifying uterine tumors and preventing misdiagnosis.

Objectives: This review provides a comprehensive analysis of copper metabolism and cuproptosis in ovarian cancer (OC), evaluating therapeutic strategies targeting copper to improve clinical outcomes. Mechanism: OC exhibits the highest mortality rate among gynecological malignancies, characterized by its insidious onset and poor prognosis, underscoring the urgent need for novel treatment strategies. Copper metabolism and cuproptosis hold promising potential in regulating tumor progression and overcoming drug resistance, thereby opening new avenues for OC treatment. This article aims to elucidate the biological basis and potential therapeutic applications of copper metabolism and cuproptosis in treating OC. Findings in Brief: Cuproptosis, a copper-dependent mechanism of cell death mechanism, disrupts mitochondrial function by inducing the aggregation of lipoylated proteins and the loss of iron-sulfur (Fe-S) clusters. Copper metabolism imbalance promotes OC progression by modulating cancer cell function, contributing to chemotherapy resistance, and influencing responses to anti-angiogenesis, and immunotherapy. Copper ionophores, chelators, copper-based nanoparticles (NPs), and certain natural molecules represent potential therapeutic strategies for the treatment of OC. Conclusions: Targeting copper metabolism and cuproptosis offers innovative therapeutic strategies for OC, particularly in cases of treatment resistance. However, clinical validation of long-term safety, optimal dosing, and biomarker-guided therapies remains critical. Future research should prioritize translational studies to bridge mechanistic insights with patient-centered applications.