Paraneoplastic Leukocytoclastic Vasculitis in Advanced Ovarian Cancer: A Case Report and Review of the Literature

Background Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis that typically presents with palpable purpura or erythematous skin lesions. While it may be triggered by infections, drugs, or autoimmune disorders, malignancy-associated vasculitis is rare and has been only exceptionally reported in ovarian cancer. Case Presentation We report the case of a 68-year-old woman with advanced ovarian carcinoma, previously treated with multiple lines of chemotherapy including platinum compounds and liposomal doxorubicin. Due to disease progression and declining performance status, she was transitioned to palliative care. During hospitalization for acute renal failure, she developed painful erythematous and purpuric lesions on both lower extremities, clinically consistent with LCV. The lesions were symmetrically distributed without necrosis or mucosal involvement. Serological investigations excluded infectious and autoimmune causes. Given her frailty and palliative status, a skin biopsy was not performed. Supportive management with local skin care and analgesia was initiated. The patient’s condition deteriorated and she passed away shortly thereafter from progressive ovarian cancer. Conclusion This case illustrates that vasculitic skin eruptions, although rare, may complicate the course of advanced ovarian cancer. In palliative settings, clinical decision-making should prioritize patient comfort and symptom control rather than invasive diagnostic procedures. Awareness of such manifestations is essential for oncologists and palliative care teams to ensure management strategies aligned with quality of life at the end of life.