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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- 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 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 • 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 • HEENT: PERRLA, EOMI Abd: • Ascites, tenderness • (+) hepatosplenomegaly Cardio: RRR
Differential Diagnosis • Colitis • Hepatic failure with ascities • Diverticulitis • Gastrointestinal malignancy • Tubo-ovarian abscess • Pelvic kidney
Laboratory Tests • Liver function tests to rule out hepatic involvement • CBC • Urinalysis • Chorionic gonadotropin- check if patient is pregnant
Imaging Tests • MRI:
Diagnosis • Ovarian cancer. Stage? 4 Additional tests: colonoscopy, x-rays
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 • Referral for palliative in home care/ at hospice • Palliative chemotherapy if desired
Possible complications • Pleural effusion • Adverse reactions to chemotherapy or radiotherapy • Bowel obstruction • Malnutrition • Electrolyte disturbances • Fistula formation • Breast carcinoma • Death