What happened, in summary

A 44-year-old woman was diagnosed with Stage III papillary ovarian cancer after evaluation for ovarian masses, ascites, and extensive peritoneal disease. Because the cancer was too widespread for immediate tumor-reduction surgery, she first received 3 cycles of carboplatin and paclitaxel chemotherapy. After a partial response, she underwent interval debulking surgery and then completed 3 more cycles of the same chemotherapy.

Follow-up was negative for about 8 months before her CA125 level rose. CT and PET/CT scans showed a suspicious area beneath the right diaphragm that appeared to be an isolated recurrence. Surgery was planned, but biopsy showed that this particular lesion was actually an inflammatory granuloma caused by a nonabsorbable surgical stitch from the earlier operation.

At the same procedure, however, surgeons unexpectedly found diffuse peritoneal cancer recurrence elsewhere in the abdomen that had not been clearly detected on imaging. After surgery, she received second-line carboplatin and Caelyx and later moved to a third line of chemotherapy. At the latest report, persistent disease remained. Her case illustrates how postoperative inflammation can mimic cancer on scans while small-volume recurrent disease may still be missed.