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Abstract: Ms. Dai, 49 years old, had been suffering from increased urination for the past 1 month. 6 days ago, she found a pelvic mass and came to our hospital to complete pathological examination, pelvic scan, ultrasound and other related examinations. Her condition is now stable and in complete remission.
Basic information】Female, 49 years old
Type of disease】Ovarian cancer
Hospital】Hunan Provincial Maternal and Child Health Hospital
Date of consultation】December 2021
Treatment plan】Surgical treatment (tumor cytoreduction, including hysterectomy and bilateral adnexal resection + pelvic lymph node dissection + para-aortic lymph node dissection + greater omentum dissection + left broad ligament posterior lobe laparotomy) + drug treatment (paclitaxel injection, carboplatin injection)
[Treatment period] 11 days of inpatient treatment, 6 months of outpatient follow-up
Treatment effect] Satisfactory tumor cytoreductive surgery was completed and R0 level was achieved
I. Initial consultation
The patient had an increased frequency of urination since one month ago, with a frequency of 1-2 hours and a medium urine volume. Yesterday, she felt intermittent vague lower abdominal pain, which was tolerable, and the abdominal pain did not improve significantly when she changed her position, and was admitted to our emergency department with “pelvic mass nature to be investigated”. After admission, the pelvic scan showed a cystic occupancy in the left adnexal region, suspected of a malignant tumor of left ovarian origin, with suspicious invasion of the left posterior wall of the uterus and the anterior rectal wall. Since the onset of the disease, the patient had a normal mental status, sleep, food and appetite, normal stool, and no significant change in weight in the past six months.
Treatment history
The patient was admitted to the hospital to complete the relevant pathological examination, and CA125 was found to be elevated. After communication with the patient and her family, she underwent surgical treatment and underwent a dissection, intraoperative resection of the left adnexa for rapid pathological examination. Defecation and gradual resumption of diet. According to the routine pathological examination, the patient was diagnosed as high-grade plasmacytoid carcinoma of ovary stage IIB, requiring 6 courses of adjuvant chemotherapy after surgery. The patient recovered well after the surgery and was discharged from the hospital.
III. Treatment effect
The patient’s pelvic mass caused bladder compression symptoms, and further examination revealed ovarian tumor, and surgical treatment was performed to completely remove the lesion and complete tumor cell reduction. After the operation, the pelvic mass was removed and the pressure and irritation of the tumor on the bladder was reduced. Postoperative recheck of CA125 was significantly decreased. The patient received chemotherapy, but had slight nausea, vomiting and other uncomfortable manifestations during the period, but it was tolerable. After chemotherapy, the blood routine, liver and kidney functions were normal on the recheck.
IV. Precautions
After the patient underwent surgery and chemotherapy, he should pay attention to his recuperation after discharge, so before discharge, I gave the patient and his family the following precautions in detail
1. Pay attention to rest after discharge, and forbid sex bathing for three months.
2, strengthen nutrition, diet should choose light and easy to digest food, cooking method is recommended to prefer steamed, boiled, eat more vitamin-rich, high-quality protein food, supplement the body’s daily needs of nutrients.
3. detect blood routine every other day after chemotherapy and monitor liver and kidney function every week.
4. taking oral anticoagulant drugs to prevent blood clots until 4 weeks after surgery for malignant tumors and paying attention to the presence of skin petechiae and ecchymosis.
5. Patients should strengthen hygiene management, keep private parts hygienic and clean, as well as keep surgical wounds dry to avoid sweat and blood contamination.
V. Personal insight
Ovarian cancer can occur in women of any age, with the highest incidence in women around menopause. Because the early symptoms are not obvious, or there are only such manifestations as discomfort in the lower back and abdomen and abdominal masses, which are easily ignored, the disease is among the most difficult to diagnose early among female genital cancers. For people at high risk of the disease, they should pay more attention to their own changes and have regular routine medical checkups, which can help detect the disease early and treat it at an early stage, which has a better prognosis for patients.