What happened, in summary

A 57-year-old woman sought care for rapidly increasing abdominal swelling and loss of appetite. Imaging showed large-volume ascites and masses involving both ovaries. Surgery and biopsy confirmed papillary serous ovarian carcinoma with deposits across the abdominal cavity, classified as Stage III. At the same time, a small vaginal lesion proved to be a separate squamous cell carcinoma.

For the ovarian cancer, she first received 6 cycles of paclitaxel and carboplatin. At interval surgery, there was no gross tumor visible in the pelvis or abdomen. She then underwent hysterectomy, removal of both ovaries and fallopian tubes, and pelvic and para-aortic lymph node dissection. The separate vaginal cancer was managed locally, including postoperative brachytherapy, and its treatment was kept distinct from the ovarian cancer pathway.

A whole-body PET scan performed 4 weeks later showed no active malignant disease, and her CA-125 level had fallen substantially. She remained on regular follow-up. The case illustrates simultaneous but histologically different cancers requiring separate treatment decisions.