Stage IV Ovarian Cancer With Severe Recurrent Ascites

What happened, in summary

A woman with a body mass index of 42 went to the emergency department with severe abdominal pain that had been present for several days. Imaging showed a 47 mm ovarian mass and enlarged groin lymph nodes. Drainage and testing of abdominal fluid found adenocarcinoma cells, leading to a diagnosis of FIGO Stage IV ovarian cancer with peritoneal carcinomatosis.

She underwent extensive surgery, including hysterectomy, removal of both ovaries and fallopian tubes, omentectomy, appendectomy, and pelvic peritonectomy. She then received 6 cycles of carboplatin and paclitaxel, followed by 3 cycles of pegylated liposomal doxorubicin during the next 2 years.

Follow-up imaging showed progression with increasing ascites, more mesenteric nodules, and an 11 cm lesion in the seventh segment of the liver. Two months later, she returned to emergency care with severe respiratory failure caused by the large volume of abdominal fluid. She died at home 16 days later. Autopsy found about 20 liters of ascites and widespread cancer deposits across the abdominal wall, intestines, liver, and other abdominal organs. Death was attributed to multiorgan failure from metastatic ovarian cancer and ascites.