Metastatic cancer can lead to enlarged pelvic lymph nodes, but enlarged pelvic lymph nodes are not necessarily caused by metastasis of cancer, but may also be caused by lymphoma, lymph node inflammation or tuberculosis, connective tissue disease and so on. 1. Metastatic cancer: stomach cancer, liver cancer, cervical cancer, ovarian cancer, colon cancer and other malignant tumors can have pelvic metastasis, resulting in enlarged pelvic lymph nodes, which are mostly accompanied by stomach discomfort and other manifestations of primary cancer. 2. Lymphoma: primary tumors of lymph nodes can also involve pelvic lymph nodes, resulting in progressive enlargement of lymph nodes. 3. Lymphadenitis or tuberculosis: pelvic infection can lead to pelvic lymphadenitis, which is often accompanied by symptoms such as lumbago and abdominal drop; when Mycobacterium tuberculosis invades pelvic lymph nodes and leads to lymphatic tuberculosis, lymph node enlargement can also occur, which is often accompanied by clinical manifestations such as low-grade fever, night sweating and a history of pulmonary tuberculosis. 4. Connective tissue diseases: systemic lupus erythematosus, tuberculosis, rheumatism and other connective tissue diseases can also lead to localized lymph node enlargement. When pelvic lymph node enlargement occurs, timely diagnosis and treatment should be made to avoid delaying the condition.