Case Presentation

CASE

• Name : Mrs. Patimah

• Age : 44 y.o (19/06/1973)
• Address : Bandung
• Medrec : 1551421

2
 HISTORY Abdomen:
Convex, soft, shifting dullnes (-), DM (-), pain
August 4th 2016 (-)
Mass (+) cystic, sized 25 x 20 x 15 cm, flat
surface, mobile
P0A0 (married 4 years)
• Abdominal mass (+) since External genitalia:
5 months before Within normal limit
admission
• Abdominal pain (-) Inspeculo:
Fluxus (-), Fluor (-)
• Vaginal bleeding (-)
Portio: within normal limit
• Leukorrhea (-)
Internal examination:
Menarche 16 y.o Vulva : within normal limit
Married 1x : 39 y.o Vaginal : within normal limit
portio : within normal limit
Corpus uteri : within normal limit
ECOG :1 Adnexa : Mass (+) cystic, sized 25 x 20
Karnofsky : 80% x 15 cm, flat surface, mobile
 LABORATORY FINDINGS
July 26th 2016

• Hb : 10.5 g/dL
• Ht : 34 %
• WBC : 6.700 /mm3
• PC : 594.000 /mm3
• Ur/Cr : 76/0.56 mg/dl
•OT/PT : 15/2 U/L
•Na/ K : 140/4,1 mEq/L

•Ca125 : 90,12 U/ml

 Abdominal Ultrasonography Result
July 26th 2016
Abdominal
Uterine : homogenous density, size 6,12 x 4,43 cm
Endometrial line (+) 0,7 cm
Adnexa : Heterogenous mass sized 16,14 x 15,94
x 14,95 cm. Septum (-). Papil (+) > 4.
acoustic shadow (-). Doppler (-). Ascites (-)
Other organ
Hepar : hypoechoic sized 3,14 x 3,11 x 2,92 cm on left lobe
Kidney : within normal limit
Conclusion : Suspected malignant ovarian tumor
Suspected hepatic tumor
IOTA Rule 3 (inconclusive) IB + 2 M (B5, M3, M4)
 August 4th 2016
Diagnosis:

Suspected malignant ovarian tumor

Suspected hepatic tumor
 WORK UP
Planned:
Salphingo-oophorectomy + VC

Post Operative:
Ovarian carcinoma (clear cell carcinoma) stage
IV B; post optimal debulking
FOLLOW UP (FEBRUARY 8TH 2017)

Diagnosis:
Ovarian carcinoma (clear cell carcinoma) stage
IV B; post suboptimal debulking; wound
dehiscence on surgery scar and vaginal stump

Planned:
Chemotherapy paclitaxel carboplatin 6 cycle
 FOLLOW UP (March 28TH 2018)

Diagnosis:
Residive ovarian carcinoma; post suboptimal
debulking; wound dehiscence; post
chemotherapy Paclitaxel Carboplatin 6 cycle

Planned:
Abdominal MSCT Scan
 Abdominal CT Scan Result
March 16th 2018
Conclusion :
• Intrahepatal metastasize
• Suspected inflamation on
mid descending colon to
distal part
• Ascites
• Billiary duct, pancreas,
adrenal, left kidney,
bladder, lymph and
peritoneum within
normal limit
THANK YOU