Ramez Eskander, MD, presents the case of a 68-year-old woman with stage IV ovarian cancer, and discusses the management approach for this patient and similar cases.
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Case Overview:
Initial Presentation
A 68-year-old postmenopausal woman presented with fatigue, urinary frequency, early satiety, abdominal bloating and distention
PMH: HTN, medically treated with lisinopril
SH: retired; grandmother of 3; never-smoker; social alcohol use
PE: abdominal distention, bloating, and a positive fluid wave test; otherwise unremarkable
Clinical work-up
Pelvic exam with transvaginal ultrasound showed a right ovarian mass
Chest/abdomen/pelvis CT with contrast revealed a right adnexal 5.3-cm complex mass, a suspicious intraparenchymal liver lesion, retroperitoneal lymph node enlargement and concurrent pleural effusion
Lymph node and adnexal mass biopsy confirmed high-grade, epithelial ovarian cancer; positive cytology of pleural effusion
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