Case: A 54-Year-Old Woman Diagnosed With Advanced Ovarian Cancer
H & P
- A 54-year-old woman presents after referral from her gynecologist for widespread tenderness, abdominal discomfort, and urinary symptoms. Pelvic exam performed by the gynecologist revealed a suspicious mass on her right ovary.
- Postmenopausal with two children
- PE: reveals an obese woman (BMI = 31 kg/m2) with mild hypertension and pre-diabetes; abdomen shows dullness to percussion
- BP = 130/85 mm Hg
- Fasting glucose = 115 mg/dL
- Waist: hip ratio = 0.90
Imaging
- CT with contrast of the pelvis, abdomen, and chest reveals widespread peritoneal lesions and abdominal lymph node involvement
- Malignant ascites present
Biopsy and labs:
- Pathology, high-grade serous adenocarcinoma, ovarian primary
- BRCA1/2 status: negative
- CA-125: 785 U/mL
Treatment
- She underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and tumor debulking; residual disease after cytoreduction = 1.1 cm
- Diagnosis, stage IIIC ovarian cancer, grade 3
- Started on every-3-week carboplatin and paclitaxel IV plus bevacizumab every 3 weeks