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Case presentation- Ovarian cancer. Agatha Stanek. Case presentation. 32 year old female patient presents to clinic with bloating. A constant sense of abdominal fullness Abdominopelvic cramping Fatigue; patient is quite pale Weight loss and a loss of appetite. Patient hx.

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Presentation Transcript
case presentation
Case presentation
  • 32 year old female patient presents to clinic with bloating.
  • A constant sense of abdominal fullness
  • Abdominopelvic cramping
  • Fatigue; patient is quite pale
  • Weight loss and a loss of appetite
patient hx
Patient hx

Medical hx:

  • Appendicitis 2 years ago
  • All immunizations are current- except HPV

Family hx:

  • Grandmother and aunt both died of breast cancer
  • Father was an alcoholic
social hx
Social hx
  • Patient is married and has been trying to conceive for 6 months now
  • Supportive husband and close- knit family
  • Lives with husband in small apartment downtown

Occupational hx

  • Patient recently graduated from law school and has begun practicing
physical exam
Physical Exam
  • HEENT:

PERRLA, EOMI

Abd:

  • Ascites, tenderness
  • (+) hepatosplenomegaly

Cardio:

RRR

differential diagnosis
Differential Diagnosis
  • Colitis
  • Hepatic failure with ascities
  • Diverticulitis
  • Gastrointestinal malignancy
  • Tubo-ovarian abscess
  • Pelvic kidney
laboratory tests
Laboratory Tests
  • Liver function tests to rule out hepatic involvement
  • CBC
  • Urinalysis
  • Chorionic gonadotropin- check if patient is pregnant
diagnosis
Diagnosis
  • Ovarian cancer.

Stage? 4

Additional tests: colonoscopy, x-rays

treatment
Treatment
  • Surgical staging
  • Chemotherapy and/ or radiotherapy- refer to oncologist
  • Biopsy of omentum and uterus
  • Inspect peritoneal surfaces, liver, small intestine and bowel for tumor
  • Pelvic and para-aortic lymph node biopsy
prognosis follow up
Prognosis/ Follow-up
  • Referral for palliative in home care/ at hospice
  • Palliative chemotherapy if desired
possible complications
Possible complications
  • Pleural effusion
  • Adverse reactions to chemotherapy or radiotherapy
  • Bowel obstruction
  • Malnutrition
  • Electrolyte disturbances
  • Fistula formation
  • Breast carcinoma
  • Death
ad