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Gynecologic Cancer Case Studies

Case Studies: A Case of Recurrent Ovarian Cancer

Expert Robert L. Coleman, MD, reviews the case of a 38-year old woman who presents with stage 3 epithelial ovarian cancer.

A Case of Recurrent Ovarian Cancer

December 2016

  • A 38-year old female presented with bloating and pain
  • PMH: unremarkable
  • FH: no malignancy
  • Abdominal/pelvic CT scan: pelvic mass (9-cm) arising from the right ovary, omental cake (15-cm), and extensive peritoneal carcinomatosis
  • CA-125: 1027 U/mL
  • The patient was diagnosed with stage IIIC epithelial ovarian cancer
  • She underwent hysterectomy, bilateral salpingo-oophorectomy, and omentectomy
    • Scattered residual peritoneal nodules (<1 cm) remained following surgery
  • Following surgery, treated with 6 cycles of IP/IV carboplatin/paclitaxel
    • After 6 cycles of therapy, CA-125 level declined to 2.5 U/mL
    • Symptoms were ameliorated

March 2017

  • Patient reported bloating and abdominal pain
  • Lab results showed elevated CA 125 (985 U/mL)
  • CT scan confirmed recurrence with ascites and visible disease (2-cm peritoneal mass)
  • She was treated with bevacizumab and topotecan for 4 cycles
    • Patient had good response therapy
    • After 4 cycles, she was switched to bevacizumab maintenance

October 2017

  • Patient returned with complaint of abdominal pain
  • CT scan revealed ascites and several 1- to 2-cm peritoneal masses in the pelvis and upper abdomen

 

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