Recurrent Ovarian Cancer With Dermatomyositis and Peritoneal Progression

What happened, in summary

A 56-year-old woman received neoadjuvant carboplatin, paclitaxel, and bevacizumab for ovarian cancer. Her first cycle was complicated by a bowel perforation. After recovering, she completed 5 more cycles, underwent optimal debulking surgery, and received 2 additional chemotherapy cycles.

About a year later, recurrent disease was treated with carboplatin and liposomal doxorubicin. Within weeks, she developed a widespread rash, shoulder pain, and muscle weakness. Examination supported dermatomyositis. Intravenous methylprednisolone followed by oral prednisolone was used while cancer treatment continued. Her shoulder weakness improved as the cancer responded.

End-of-treatment imaging later showed low-volume peritoneal progression. After a period of observation, weekly paclitaxel was started. The cancer continued to progress, and she was considered too unwell for further treatment. Her dermatomyositis did not recur during this later progression.