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Abstract: A 46-year-old female patient reported that she found a mass in her ovary during a physical examination 2 days ago and did not feel any abnormal adverse physical symptoms before, so she came to our hospital for further examination to clarify the specific cause of the mass in her ovary. Combining the patient’s symptoms, signs and CT examination results, the patient was finally diagnosed with granulosa cell tumor of the ovary, and after surgery and drug treatment, her condition was well controlled and the indicators returned to normal.
Basic information】Female, 46 years old
Disease Type】Granulosa cell tumor (ovarian granulosa cell tumor)
Hospital】Qilu Hospital of Shandong University
Date of consultation】August 2019
Treatment plan】Surgical treatment (ovarian cancer full-scale staging surgery) + intravenous drugs (doxorubicin hydrochloride injection, cyclophosphamide for injection) + oral drugs (amoxicillin capsules)
Treatment period】In-hospital treatment for 10 days, and monthly review after discharge
Treatment effect] The disease has been controlled, the abdominal mass disappeared, and the indicators returned to normal.
I. Initial consultation
When I first saw the patient in the hospital, the patient described to me that she had not suffered from hypertension, tumor or other diseases before and had no history of surgery, and reported that she found a mass in her ovary during a physical examination two days ago. During the patient’s physical examination, a hard mass with average mobility was palpated in her lower abdomen. After completing CT examination, the patient showed oval-shaped masses in both adnexal areas with clear borders and heterogeneous densities, and smooth walls of cystic areas of varying sizes were seen inside. Combining the patient’s symptoms, signs and CT examination results, the patient was suspected to have ovarian granulosa cell tumor and was admitted to the hospital immediately.
Treatment
Because of the relatively rapid growth of the tumor, the patient was advised to undergo surgery as soon as possible to avoid disease progression, and the patient expressed willingness to accept treatment and signed the informed consent for surgery. The patient was put under general anesthesia and the skin of the operating area was disinfected. A surgical incision was made in the patient’s abdomen, and the muscles and fascia were cut open layer by layer, and the uterus, both adnexa, greater omentum, pelvic lymph nodes and para-aortic lymph nodes were removed. In order to prevent secondary infection after surgery, amoxicillin capsules were prescribed for the patient. Meanwhile, in order to avoid the recurrence of tumor cells, chemotherapy treatment was also required after surgery, and the drugs used included doxorubicin hydrochloride injection and cyclophosphamide for injection.
III. Treatment effect
On the first day after surgery, the patient’s mental status was good, body temperature was 36.7℃, no fever was observed, pain at the surgical incision site was said to be tolerable, drainage fluid in the drainage tube was clear, and no other adverse symptoms were observed. On the 10th day of in-hospital treatment, the surgical incision healed well, the patient’s diet and sleep were normal, the abdominal masses disappeared during physical examination, and no oval-shaped masses in the bilateral adnexal area were seen on the re-examination of CT.
IV. Notes
I was happy to see the patient discharged happily, and I felt happy for the patient from the bottom of my heart. At the time of discharge, I advised the patient that since the surgical incision was not completely healed, he should avoid drastic movements for a short period of time to prevent the wound from tearing, and he should not scratch the surgical incision to avoid secondary infection.
If symptoms such as vomiting, constipation, hair loss, fatigue, etc. occur during chemotherapy, you should consult a doctor promptly and have a monthly review. The patient should eat more fish, milk, apples and other highly nutritious and light foods, exercise appropriately, maintain a calm mind and regular work and rest, which can help the patient’s own condition to improve.
V. Personal insight
Although the disease of cancer sounds terrible, after early treatment, the disease will be better controlled, alleviate the adverse symptoms caused by tumor invasion, and improve the quality of life of cancer patients to a certain extent. Like the 46-year-old female patient in this case, after targeted treatment with surgery, chemotherapeutic drugs and anti-infective drugs, the patient has been discharged from the hospital and no tendency of tumor recurrence or disease worsening was seen at the time of review. In addition, from this case, we can learn more about the importance of regular medical checkups, which can also help to clarify the disease as early as possible.