What happened, in summary

A woman in her 50s developed increasing abdominal swelling, discomfort, reduced appetite, and shortness of breath. Imaging showed a large ovarian mass with peritoneal and nodal spread. A biopsy of omental tissue showed high-grade serous carcinoma of probable ovarian origin, and biopsy of the ovarian tumor supported the same diagnosis. Her disease was documented as Stage III.

Her presentation was unusual because her blood amylase level was more than 30 times the upper limit of normal, initially raising concern for pancreatitis. Further testing showed that the excess amylase was not coming from the pancreas and appeared to track with the ovarian cancer. During the same admission, she also developed pulmonary emboli that required urgent treatment.

She received 3 cycles of carboplatin and paclitaxel before surgery and had an excellent initial clinical and imaging response. She then underwent hysterectomy, removal of both ovaries and fallopian tubes, omentectomy, and appendectomy. At 6 months after presentation, she was receiving 3 more chemotherapy cycles. Her amylase and CA-125 levels fell with tumor shrinkage and later rose and fell again during periods of progression and response. Her case highlights both a serious clotting complication and an unusual laboratory marker that closely paralleled her ovarian cancer course.