Stage III Ovarian Cancer During Care for Common Variable Immunodeficiency

What happened, in summary

A woman in her early 60s had common variable immunodeficiency requiring intravenous immunoglobulin and a history of stage 3 ovarian cancer treated with surgery and chemotherapy. She later continued maintenance bevacizumab for ovarian cancer.

During maintenance treatment, she presented with cough, coughing up blood, shortness of breath, night sweats, weight loss, and intermittent fever. Chest imaging showed a 2.1 cm left hilar mass with mucus plugging and enlarged hilar lymph nodes. Bronchoalveolar lavage grew Mycobacterium avium complex-intracellulare. She also had bronchiectasis, increasing the complexity of care alongside her immune deficiency and cancer treatment.

Her respiratory symptoms were controlled, and serial chest CT findings remained stable while she received azithromycin, ethambutol, and amikacin 3 days each week, as well as ongoing intravenous immunoglobulin. From the ovarian-cancer perspective, she was alive on maintenance bevacizumab, and radiologic follow-up showed no evidence of progression.