Case Presentation
This woman in her late 40’s, with a parity of 1, had a medical history
of asthma and a BMI of 37. She was referred from the cancer unit to our
cancer centre with a suspected recurrence of ovarian cancer.
The patient had a history of
grade 1 endometrioid ovarian cancer, FIGO Stage 1C2, treated 4 years
prior to the referral in a cancer unit with surgery (total abdominal
hysterectomy, bilateral salpingo-oopherectomy, omentectomy, and
peritoneal washings) followed by five cycles of chemotherapy
(Carboplatin / Paclitaxel).
A
sixth cycle of chemotherapy was not administered due to toxicity. The
patient was followed up with 4 monthly appointments in the first two
years post-surgery, then 6 monthly appointments. At a follow-up
appointment in the third year post surgery, the patient reported mild
abdominal discomfort and intermittent lower back pain and had a CA 125
of 42 ku/L. A CT AP was requested and this identified a complex pelvic
mass, of approx. 7cm in max. diameter. The imaging was discussed at the
Oxford multidisciplinary meeting (MDT) and a decision was made for a
diagnostic laparoscopy. A tissue biopsy was obtained and was in keeping
with an atypical endometrioma. The patient had GnRH analogues for 6
months followed and serial imaging.