April 15, 2020


Case: A 59-Year Old Female With Stage IIIC Ovarian Cancer

Initial Presentation

  • A 59-year old female presented with new onset early satiety, abdominal bloating and discomfort
  • PMH: unremarkable, postmenopausal
  • SH: schoolteacher; no tobacco, alcohol or drug use
  • PE: abdominal distention, left lower quadrant tender on palpation, shifting dullness noted on percussion

Clinical work-up

  • Pelvic exam with transvaginal ultrasound showed a left ovarian mass
  • Chest/abdomen/pelvis CT with contrast revealed a left adnexal 4.8-cm mass, extension to liver capsule without parenchymal involvement; retroperitoneal lymph node involvement and ascites noted; no pleural effusion
  • Lymph node, adnexal mass biopsy, and paracentesis (2000 cc) cytology confirmed high-grade epithelial ovarian cancer
  • Diagnosis: high-grade epithelial ovarian cancer; stage IIIC — T3cN1M0
  • Germline/molecular testing showed HRD-,BRCA1/2wild—type
  • CA-125, 385 U/mL
  • ECOG PS 1

Treatment

  • Patient underwent TAH/BSO, lymph node dissection, with optimal debulking; R0
  • IP/IV paclitaxel/carboplatin + bevacizumab every 3 weeks for 6 cycles
    • Followed by bevacizumab for 6 more cycles
    • Complete response; post treatment CA—125, 48 U/mL

Follow-up

  • 3-months CA-125, 30 U/mL
  • Chest/abdomen/pelvis CT showed no gross pelvic masses or nodes
  • Pelvic exam, unremarkable
  • ECOG PS 0