In the last 10 years, the marker “Human Epididymis protein 4 (HE4)” for the management of gynecological tumors has entered powerfully in the world literature. At the moment, carrying out an accurate research in the main scientific portals such as PubMed, we can find more than 2,000 works concerning Cancer antigen-125 (Ca125), but those concerning HE4 are less than 400. The assessment of the prognostic significance of Ca125 has been described in more than 1000 scientific papers, whereas in the case of HE4 such works are only about 100.

Ovarian cancer stands as the most lethal gynecologic malignancy and remains the fifth most common gynecologic cancer. Poor prognosis and low five-year survival rate are attributed to nonspecific symptoms at early phases along with a lack of effective treatment at advanced stages. It is thus paramount, that ovarian carcinoma be viewed through several lenses in order to gain a thorough comprehension of its molecular pathogenesis, epidemiology, histological subtypes, hereditary factors, diagnostic approaches, and methods of treatment.

Interleukin (IL)-2 was first identified as a potent T cell growth factor in 1976 and cloned in 1983. In the late 1990s, IL-2 gained further attention as the first immunotherapy demonstrating clinical efficacy against metastatic cancer, as high dose IL-2 was approved by the United States Food & Drug Administration (FDA) for the treatment of metastatic renal cell carcinoma in 1992 and metastatic melanoma in 1998.

Ovarian cancer affects 15 women per 100,000 in Europe [1] but it is not one disease. Epithelial malignancy the most common type of ovarian malignancy and defines the groups termed carcinoma [2,3]. Other malignant subtypes include sarcomas, germ cell tumors and sex-cord stromal tumors [1]. Ovarian carcinomas are subdivided based on histological features, the most common being high-grade serous carcinoma which makes up around 70% of ovarian carcinomas [2,4]. Up to 10% of ovarian carcinomas are endometrioid subtype, having phenotypic and molecular resemblances to endometroid adenocarcinomas that arise in the endometrial cavity [3,5] Clear cell carcinoma (OCCC) and endometrioid carcinoma of the ovary (EnOC) occur on a background of ovarian endometriosis in as many as 70% of cases [6,7]. OCCC is equally as common as endometroid type, perhaps reflecting this shared origin and collectively are often referred to as Endometriosis-Associated Ovarian Carcinomas (EAOCs). Mucinous carcinoma is less common than endometriosisrelated carcinomas at around 3% of ovarian carcinomas [2].

Pleomorphic rhabdomyosarcoma (PRMS) is a rare and aggressive soft tissue sarcoma that typically occurs in the extremities of older adults. Involvement of the splenic hilum is extremely rare and has not been previously reported in the literature. We present the case of an 81-year-old female with a remote history of high-grade serous carcinoma of the ovary who presented with new-onset vaginal bleeding. Imaging revealed a mass in the left upper quadrant at the interface of the spleen and pancreatic tail.