A 38-year old female presented to her gynecologist with abdominal distension, abdominal pain, fullness after eating, and increased urination frequency for 2 months
Pelvic examination revealed a suspicious mass on the left ovary
Laboratory findings:
CA-125: 785 U/ml
Genetic testing forBRCA1/2, negative
CT with contrast of the pelvis, abdomen, and chest indicated widespread peritoneal lesions
She was referred to gynecologic oncology and underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and tumor debulking; She had diffuse studding in the omentum and diaphragmatic surfaces
Stage 3C ovarian cancer
She achieved complete removal of gross residual disease (R0)
The patient was started on therapy with carboplatin and every-3-weekly paclitaxel
October 2016
Post-treatment assessment revealed no evidence of disease
March 2017
Patient complained of fatigue and chest pain
Physical examination:
Lungs, moist rales bilaterally
Abdomen, shifting dullness
Laboratory findings: CA-125: 1,052 U/ml
CT imaging: left-sided pleural effusion and sclerotic lesions in the lung apical region, ascites, new hypodense lesions in the right lobe of the liver and enlarged retroperitoneal nodes were considered metastatic
She was started on therapy with weekly paclitaxel and bevacizumab