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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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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


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