Metastasis of Residive Mucinous Ovarian Carcinoma to Umbilicus, Peritoneum, And Ascites Fluid With No Malignancy Marker Found in The Previous Post-Operative Histopathological Examination

Arif Fadillah, Andi Friadi

Abstract


Background : Malignant ovarian tumor are still the number one cause of death and the second most  of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.

Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.

Method : Case report

Case : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluid

Keywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma

Full Text:

PDF

References


Busmar, B. Kanker Ovarium. Dalam Buku Acuan Nasional Onkologi Ginekologi. Editor: M.F. Azis, Andrijono, dan A.B. Saifuddin. Jakarta:Yayasan Bina Pustaka Sarwono Prawirohardjo, 2010: 524-468.

Prawirohardjo, S. Ilmu Kandungan. Jakarta: Yayasan Bina Pustaka Sarwono Prawirohardjo. 2014.

De Jong, W. Tumor Ovarium dalam Buku Ajar Ilmu Bedah 4th ed. Jakarta: EGC. 2014: 730- 729.

Kumar V, Cotran RS, and Robbins SL. Robbins Basic Pathology 8th ed. New York: W.B. Saunders Company. 2007.

Cuningham, F.G., et al. (2018) Williams Obstetrics, 25th ed, United States: The McGraw-Hill.

Tantri,H. Penilaian Akurasi Diagnosis Potong Beku Pada Tumor Ovarium Jenis Epitel di Departemen Patologi Anatomi RSCM 2009-2011. Jakarta : Majalah Patologi. 2012. Vol 21: 43-37.

Doubeni CA, Doubeni ARB, Myers AE. Diagnosis and Management of Ovarian Cancer. Perelman School of Medicine, University of Pennsylvania. American Academy of Family Physicians 2016. vol 93: 937-44

Burges A, Schmalfteldt B. Ovarian Cancer: Diagnosis and Treatment. Dtsch Arztebl Int 2011; 108(38): 635-41

27th FIGO annual report on the result of treatment in gynecology cancer. Int. J Gynecol Obstet. 2006.

Callahan TL, Caughey AB. Blueprints Obstetrics & Gynecology ed 7th: Philadelphia. Wolters Kluwer, 2018; hal. 1024-44

Panduan Praktik Klinik Kanker Ovarium RSUPN Cipto Mangunkusumo, Jakarta : 2017.

Panduan Praktik Klinik Tumor Ovarium RSUP DR.M.Djamil, Padang : 2018.




DOI: https://doi.org/10.25077/aoj.3.2.130-136.2019

Refbacks

  • There are currently no refbacks.