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Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report

Received: 19 May 2014     Accepted: 20 June 2014     Published: 30 June 2014
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Abstract

Introduction: Ovarian cancers are gynaecological malignancies described as the most lethal because they often present at the advanced stages. Metastasis to the liver parenchyma occurs in stage IVB disease. The diaphram is a tumour sanctuary site as most deposits are missed during cytoreductive surgeries and chemotherapy. Materials and method: This is a case presentation of a 39 year old lady with recurrent huge multicystic ovarian cancer with liver and diaphragmatic involvement. Abdominal ultrasound scan and a CT-scan were done amongst other investigations. This patient was co-managed by the Hepato-Pancreato-Biliary surgeons, Cardiothoracic Surgeons and the Gynaecologic oncologist. She had cytoreductive surgery and adjuvant chemotherapy. Conclusion: Diaphragmatic involvement from ovarian tumour is rare and represents an advanced disease. The superiority of CT-scan over abdominal ultrasound scan in this case is incontrovertible. A multidisciplinary approach is an important cornerstone in it’s management.

Published in Journal of Cancer Treatment and Research (Volume 2, Issue 3)
DOI 10.11648/j.jctr.20140203.11
Page(s) 21-26
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Ovarian Cancers, Liver and Diaphragmatic Involvement, CT-Scan

References
[1] SEER. Cancer statistics, 2013. http://seer.cancer.gov/statistics/html/ovary/html accessed 14th March 2014
[2] Nashmia JAM, Tien L. Does modality of adjuvant chemotherapy after interval surgical debulking matter in epithelial ovarian cancer. IJGC 2014; 24(3): 461-467
[3] Oguz Akin, Evis Sala, Chaya S Moskowitz,Nicole Ishill ,Richard A Soslow ,Dennis S Chi , Hedvig Hricak . Perihepatic metastasis from ovarian cancer:Sensitivity and specificity of CT for the detection of metastasis with and those without liver parenchymal invasion. Radiology 2008 248:511-517 .
[4] Edwards JM, Lowery WJ, Secord AA. Primary debulking for epithelial ovarian cancer. JSCR ,2012 7:7
[5] Bosquet JG, Merideth MA, Podratz KC, Nagorny DM .Hepatic resection for metachronous metastasis from ovarian carcinoma . HPB (Oxford), 2006 April 1; 8(2):
[6] Bristow RE, Montz FJ, Lagasse LD, Leuchter RS, Karlan BY. Survival impact of surgical cytoreduction in stage IV epithelial ovarian cancer. Gynecol Oncol. 1999 Mar;72(3):278-87.
[7] Scarabelli C, Gallo A, Carbone A. Secondary cytoreductive surgery for patients with recurrent epithelial ovarian carcinoma. Gynecol Oncol. 2001 Dec;83(3):504-12.
[8] Jose M. Ramia*, Roberto De La Plaza, Jose Quiñones, Pilar Veguillas, Farah Adel, Jorge García-Parreño. Liver Metastases from Gynecological Cancers: Time to Resection? Surgical Science, 2012, 3, 120-125
[9] Merideth MA, Cliby WA, Keeney GL, Lesnick TG, Nagorney DM, Podratz KC. Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol. 2003 Apr;89(1):16-21.
[10] Guang-cai Niu, Chang-ming Shen, Wei Cui, Qiang Li. Hepatic Resection is Safe for Metachronous Hepatic Metastases from Ovarian Cancer. Cancer Biol Med. 2012 September; 9(3): 182–187
[11] Hepatic resection for metastatic gynecologic carcinomas.Gynecol Oncol. 1997 Jul;66(1):45-51.Chi DS, Fong Y, Venkatraman ES, Barakat RR.
[12] Lim MC, Kang S, Lee KS, Han SS, Park SJ, Seo SS, Park SY. The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer. Gynecol Oncol. 2009 Jan;112(1):28-34.
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  • APA Style

    Ngim, Ogbu Ewezu, Ago, Boniface Uji, Ogbudu Stephen, et al. (2014). Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report. Journal of Cancer Treatment and Research, 2(3), 21-26. https://doi.org/10.11648/j.jctr.20140203.11

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    ACS Style

    Ngim; Ogbu Ewezu; Ago; Boniface Uji; Ogbudu Stephen, et al. Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report. J. Cancer Treat. Res. 2014, 2(3), 21-26. doi: 10.11648/j.jctr.20140203.11

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    AMA Style

    Ngim, Ogbu Ewezu, Ago, Boniface Uji, Ogbudu Stephen, et al. Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report. J Cancer Treat Res. 2014;2(3):21-26. doi: 10.11648/j.jctr.20140203.11

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  • @article{10.11648/j.jctr.20140203.11,
      author = {Ngim and Ogbu Ewezu and Ago and Boniface Uji and Ogbudu Stephen and Nwagboso Chima and Echei Chidiebere and Etiuma and Anietimfom Umoh and Bassey and Okon Odokwo and Ndoma-Egba Rowland},
      title = {Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report},
      journal = {Journal of Cancer Treatment and Research},
      volume = {2},
      number = {3},
      pages = {21-26},
      doi = {10.11648/j.jctr.20140203.11},
      url = {https://doi.org/10.11648/j.jctr.20140203.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20140203.11},
      abstract = {Introduction: Ovarian cancers are gynaecological malignancies described as the most lethal because they often present at the advanced stages. Metastasis to the liver parenchyma occurs in stage IVB disease. The diaphram is a tumour sanctuary site as most deposits are missed during cytoreductive surgeries and chemotherapy. Materials and method: This is a case presentation of a 39 year old lady with recurrent huge multicystic ovarian cancer with  liver and diaphragmatic involvement. Abdominal ultrasound scan and a CT-scan were done amongst other investigations. This patient was co-managed by the Hepato-Pancreato-Biliary surgeons, Cardiothoracic Surgeons and the Gynaecologic oncologist. She had cytoreductive surgery and adjuvant chemotherapy. Conclusion: Diaphragmatic involvement from ovarian tumour is rare and represents an advanced disease. The superiority of CT-scan over abdominal ultrasound scan in this case is incontrovertible. A multidisciplinary approach is an important cornerstone in it’s management.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Huge Metastatic Multicystic Ovarian Cancer with Liver Involvement: A Case Report
    AU  - Ngim
    AU  - Ogbu Ewezu
    AU  - Ago
    AU  - Boniface Uji
    AU  - Ogbudu Stephen
    AU  - Nwagboso Chima
    AU  - Echei Chidiebere
    AU  - Etiuma
    AU  - Anietimfom Umoh
    AU  - Bassey
    AU  - Okon Odokwo
    AU  - Ndoma-Egba Rowland
    Y1  - 2014/06/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.jctr.20140203.11
    DO  - 10.11648/j.jctr.20140203.11
    T2  - Journal of Cancer Treatment and Research
    JF  - Journal of Cancer Treatment and Research
    JO  - Journal of Cancer Treatment and Research
    SP  - 21
    EP  - 26
    PB  - Science Publishing Group
    SN  - 2376-7790
    UR  - https://doi.org/10.11648/j.jctr.20140203.11
    AB  - Introduction: Ovarian cancers are gynaecological malignancies described as the most lethal because they often present at the advanced stages. Metastasis to the liver parenchyma occurs in stage IVB disease. The diaphram is a tumour sanctuary site as most deposits are missed during cytoreductive surgeries and chemotherapy. Materials and method: This is a case presentation of a 39 year old lady with recurrent huge multicystic ovarian cancer with  liver and diaphragmatic involvement. Abdominal ultrasound scan and a CT-scan were done amongst other investigations. This patient was co-managed by the Hepato-Pancreato-Biliary surgeons, Cardiothoracic Surgeons and the Gynaecologic oncologist. She had cytoreductive surgery and adjuvant chemotherapy. Conclusion: Diaphragmatic involvement from ovarian tumour is rare and represents an advanced disease. The superiority of CT-scan over abdominal ultrasound scan in this case is incontrovertible. A multidisciplinary approach is an important cornerstone in it’s management.
    VL  - 2
    IS  - 3
    ER  - 

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Author Information
  • Division of Cardiothoracic Surgery, Department of Surgery, University of Calabar and University of Calabar Teaching Hospital , Calabar, Cross River State, Nigeria

  • Division of Cardiothoracic Surgery, Department of Surgery, University of Calabar and University of Calabar Teaching Hospital , Calabar, Cross River State, Nigeria

  • Division of Cardiothoracic Surgery, Department of Surgery, University of Calabar and University of Calabar Teaching Hospital , Calabar, Cross River State, Nigeria

  • Division of Hepatopancreatobiliary Surgery, Department of Surgery, University of Calabar and University of Calabar Teaching Hospital , Calabar, Cross River State, Nigeria

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