What happened, in summary

A 58-year-old postmenopausal woman presented with increasing abdominal size and vague abdominal pain. Imaging showed a large ovarian mass, abdominal lymph-node enlargement, peritoneal disease, and multiple enlarged axillary lymph nodes. Breast imaging did not show a breast tumor. Sampling of an axillary node confirmed that the cancer had spread there from the ovary, establishing Stage IV ovarian cancer.

She first received 6 cycles of chemotherapy. Follow-up imaging showed a modest response, including shrinkage of the abdominal disease and disappearance of the visible axillary-node disease.

She then underwent cytoreductive surgery with removal of the uterus, both ovaries and fallopian tubes, the omentum, and selected abdominal lymph nodes. Pathology confirmed serous ovarian carcinoma involving both ovaries, with cancer also present in iliac lymph nodes and peritoneal nodules.

After recovering from surgery, she completed 3 additional cycles of chemotherapy. She remained under oncology follow-up through her last recorded visit in October 2017.