Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

2001 ◽  
Vol 11 (4) ◽  
pp. 290-294 ◽  
Author(s):  
T. Bilgin ◽  
A. Karabay ◽  
E. Dolar ◽  
O. H. Develioğlu
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Abdominal Mass ◽  
Gynecologic Cancer ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
Advanced Ovarian Carcinoma ◽  
Abdominal Paracentesis

Abstract.Bilgin T, Karabay A, Dolar E, Develioğlu OH. Peritoneal tuberculosis with pelvic abdominal mass, ascites, and elevated CA 125 mimicking advanced ovarian carcinoma.Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 ± 6.1 (median 37; range 18–72). Ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40–560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. Patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.

Carboplatin (JM 8), Adriamycin and Cyclophosphamide (JAC) in Advanced Ovarian Carcinoma: A Pilot Study

1988 ◽  
Vol 74 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Pier Franco Conte ◽  
Milena Bruzzone ◽  
Silvana Chiara ◽  
Riccardo Rosso ◽  
Giuseppe Giaccone ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pilot Study ◽  
Ovarian Carcinoma ◽  
Dose Level ◽  
Combination Treatment ◽  
Renal Toxicity ◽  
Advanced Ovarian Cancer ◽  
Hematologic Toxicity ◽  
Advanced Ovarian Carcinoma ◽  
Dose Limiting Toxicity

Eleven untreated patients with advanced ovarian cancer were studied for tolerance and response to combination treatment with fixed doses of adriamycin (45 mg/m2) and cyclophosphamide (600 mg/m2) + escalating doses of carboplatin. At the first dose level of carboplatin (200 mg/m2), toxicity was acceptable. With carboplatin at 300 mg/m2, severe hematologic toxicity was observed. The dose-limiting toxicity was leukopenia. Although carboplatin was administered without any hydration, no patient experienced renal toxicity. Eight objective responses were observed in 9 clinically evaluable patients. At second look surgery, 3 complete responses and 4 partial responses were documented. Polychemotherapy with JAC (carboplatin, 200 mg/m2, adriamycin, 45 mg/m2, and cyclophosphamide, 600 mg/m2) is administrable with acceptable toxicity.

Peritoneal tuberculosis with elevated serum Ca-125 level mimicking advanced stage ovarian cancer: a case report

2009 ◽  
Vol 280 (2) ◽  
pp. 333-335 ◽  
Author(s):  
Orkun Tan ◽  
Edward Luchansky ◽  
Stephen Rosenman ◽  
Tarah Pua ◽  
Masoud Azodi
Keyword(s):  
Ovarian Cancer ◽  
Case Report ◽  
Elevated Serum ◽  
Ca 125 ◽  
Advanced Stage ◽  
Peritoneal Tuberculosis

Early-stage ovarian carcinoma combined with pulmonary tuberculosis mimicking advanced ovarian cancer: a case report

2004 ◽  
Vol 14 (5) ◽  
pp. 1007-1011
Author(s):  
C.-H. Chen ◽  
C.-Y. Huang ◽  
S.-N. Chow
Keyword(s):  
Ovarian Cancer ◽  
Pulmonary Tuberculosis ◽  
Early Stage ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Stage Iv ◽  
Malignant Cell ◽  
Cytotoxic Chemotherapy ◽  
Ca 125 ◽  
Lung Lesions

In patients of ovarian cancer combined with multiple pulmonary nodules, the diagnosis of metastatic ovarian cancer is always considered. However, benign pulmonary conditions can be discovered instead. An 80-year-old female presented with a rapidly growing ovarian mass, elevated serum CA-125, and multiple pulmonary varying-sized nodular lesions. The pretreatment workup of her lung lesions failed to show a malignant cell, and it also failed to show any evidence of tuberculosis or other infectious diseases. After surgery, her disease was allotted to ‘stage IV’ epithelial ovarian cancer and adjuvant cytotoxic chemotherapy was then used. However, her sputum culture showed positive growth of Mycobacterium tuberculosis 4 weeks later. For fear of reactivation of pulmonary tuberculosis, the anticancer cytotoxic chemotherapy was postponed and the antituberculous treatment was given instead. After 6-month course of antituberculous therapy, no active lung lesion was detectable. In conclusion, infectious or inflammatory conditions can mimic metastatic disease and therefore add to the difficulty of stage determination. We recommend that there must be positive cytologic or pathologic results of lung lesions to allot a case of ovarian cancer to stage IV. Furthermore, whenever pulmonary lesions are seen on imaging, the possibility of diagnoses other than metastatic ovarian cancer should always be considered.

Clinical efficacy and safety of apatinib combined with oral VP-16 for the treatment of advanced ovarian cancer: Preliminary evaluation of a clinical drug regimen

2020 ◽  
Vol 6 (2) ◽  
pp. 209-213
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Clinical Efficacy ◽  
Advanced Ovarian Cancer ◽  
Symptomatic Treatment ◽  
Drug Regimen ◽  
Preliminary Evaluation ◽  
Efficacy And Safety ◽  
Advanced Ovarian Carcinoma ◽  
Hand Foot Syndrome

To investigate the clinical efficacy and safety of apatinib in combination with oral VP-16 for the treatment of chemotherapy-resistant advanced ovarian carcinoma. Twenty-seven advanced ovarian carcinoma patients were treated with oral VP-16 chemotherapy combined with oral apatinib mesylate (500 mg/d). CA125, VEGF, and CEA were examined every 3-4 weeks, and tumour changes were monitored by CT every 8-12 weeks. PFS was obtained by follow-up after discharge. For all patients, the ORR (including CR and PR) was 25.0%, and the DCR (including CR, PR and SD) was 75.0%. CEA and CA199 significantly decreased (p<0.05), but the decrease in VEGF was not significant. The average PFS was 5.13 months. The ECOG score had a significant effect on PFS (p<0.05), while there were no significant differences in PFS based on age (p=0.394). The main side effects of this regimen were hypertension, proteinuria, hand-foot syndrome and myelosuppression, which were tolerated by patients after active symptomatic treatment. Apatinib combined with oral VP-16 is an effective regimen for the treatment of chemotherapy-resistant advanced ovarian cancer. This combination therapy should be widely used in clinical practice.

Phase II study of carboplatin followed by sequential gemcitabine and paclitaxel as first-line treatment for advanced ovarian cancer

2007 ◽  
Vol 17 (2) ◽  
pp. 350-358 ◽  
Author(s):  
M. Friedlander ◽  
M. Buck ◽  
D. Wyld ◽  
M. Findlay ◽  
B. Fitzharris ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Gynecologic Cancer ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Line Treatment ◽  
First Line ◽  
Sequential Approach ◽  
First Line Treatment

The aim of this exploratory phase II study was to evaluate sequential chemotherapy with carboplatin followed by gemcitabine–paclitaxel combination in chemonaive patients with advanced ovarian cancer. The primary objective was to evaluate time to progressive disease (TTPD); secondary objectives included the evaluation of 1- and 3-year survival, response rates, and toxicity. Following initial debulking surgery or biopsy, patients with FIGO stage IIC–IV disease received four cycles of carboplatin area under the curve (AUC) 6 (day 1) every 21 days, followed by four cycles of gemcitabine 1000 mg/m2 (days 1 and 8) and paclitaxel 175 mg/m2 (day 8) every 21 days. A total of 47 patients enrolled, 44 (93.6%) completed the initial four cycles, and 39 patients (82.9%) completed the planned eight cycles. The median and maximum lengths of follow-up were 31.2 and 43.7 months, respectively. Median TTPD was 13.8 months (95% CI, 11.6–21.0 months), and median survival time was 31.2 months (95% CI, 25.2–39.6 months). Survival at 1 and 3 years was 95.7% and 44.2%, respectively. Of the 43 evaluable patients, most (95.3%) of them achieved a CA-125 marker response based on Gynecologic Cancer Intergroup (GCIG) definition. The partial response rate in the seven patients with measurable disease was 46.4%. Myelosuppression was the major toxicity, with grade 3 and 4 neutropenia observed in 76.6% patients and thrombocytopenia in 12.8% patients. The sequential approach of carboplatin followed by gemcitabine–paclitaxel as first-line treatment for patients with ovarian cancer is feasible and well tolerated, and depending upon the findings from other major trials, it may merit further evaluation.

Thoracoscopic Resection of Fluorodeoxyglucose-Avid Mediastinal Lymph Nodes Associated with Advanced Ovarian Carcinoma

2018 ◽  
Vol 67 (08) ◽  
pp. 692-696
Author(s):  
Masatsugu Hamaji ◽  
Ken Yamaguchi ◽  
Sho Koyasu ◽  
Hiroshi Date
Keyword(s):  
Ovarian Cancer ◽  
Lymph Nodes ◽  
Ovarian Carcinoma ◽  
Advanced Ovarian Cancer ◽  
Mediastinal Lymph Nodes ◽  
Thoracoscopic Resection ◽  
Advanced Ovarian Carcinoma ◽  
Histological Confirmation ◽  
Long Term Mortality

AbstractThe indication for surgery is controversial in patients with advanced ovarian cancer and fluorodeoxyglucose (FDG)-avid mediastinal lymph nodes. Herein we report our experience in thoracoscopic resection of FDG-avid mediastinal lymph nodes associated with advanced ovarian cancer in six patients. No perioperative or long-term mortality was noted. FDG-avid mediastinal lymph nodes in advanced ovarian carcinoma may merit thoracoscopic resection with histological confirmation for more precise staging.

scholarly journals A Diagnostic Challenge: Peritoneal Tuberculosis Mimicking Ovarian Cancer

2016 ◽  
Vol 16 (2) ◽  
pp. 31-32
Author(s):  
Eva Rulova ◽  
Elizabete Pumpure ◽  
Zenons Romanovskis ◽  
Liga Puksta-Gulbe
Keyword(s):  
Ovarian Cancer ◽  
Abdominal Pain ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Elevated Serum ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
First Line ◽  
Diagnostic Challenge ◽  
Preoperative Examination

SummaryA 26 years old patient was admitted to hospital with complaints of abdominal pain and febrile temperature. Initially, elevated serum antigen CA-125, ascites and multiple suspicious nodules in the lungs and abdominal cavity on CT were found, thus, diagnosing ovarian cancer. However, after further preoperative examination, the diagnosis of infiltrative pulmonary tuberculosis with extrapulmonary involvement was set, thereby cancelling the surgery. The patient was treated with first-line antituberculosis agents and discharged home. Almost in all other cases, peritoneal tuberculosis is diagnosed only after surgical intervention.

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