p53
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A 52-year-old woman has had increasing abdominal enlargement, with no significant pain, and diarrhea for the past 2 months. She goes to the physician, who finds a fluid wave on examination of the abdomen. Stool culture is negative. An abdominal CT scan shows massive ascites and scattered 1-cm cystic to solid nodules on the surfaces of the bowel and abdominal wall. Paracentesis yields a yellow, slightly cloudy fluid with a high protein content. Cytologic examination of the fluid shows clusters of malignant cells. Laboratory studies show a positive CA-125 and a negative carcinoembryonic antigen test result. The patients medical history indicates that she underwent a total abdominal hysterectomy with salpingo-oophorectomy 12 years ago. Which of the following is the most likely diagnosis ?
A. Adenocarcinoma of the colon
B. Endometrioid carcinoma
C. Malignant mesothelioma
D. Metastatic ovarian serous cystadenocarcinoma
E. Mucinous cystadenocarcinoma
F. Serous peritoneal carcinoma
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| SA
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D. Metastatic ovarian serous cystadenocarcinoma
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| fleuve
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D seems right, ca-125 ofetn come with ovary epithelial carcinoma , ovary epithelial carcinoma always spread to the peritoneal cavity, and serous type often with the highest ca-125, however mucinous type with the lowest.
however,i do not know
she underwent a total abdominal hysterectomy with salpingo-oophorectomy 12 years ago, she do not have ovary , tube and uterus, how can she has ovary cancer?
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| p53
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D is not correct.
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| ssrpk
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it's e
appendicieal mucinous cystadenocarcinoma alsio present with psudomyxoma peritonei!
but why is CA-125 +ve??
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| mjl1717
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fleuve wrote:
D seems right, ca-125 ofetn come with ovary epithelial carcinoma , ovary epithelial carcinoma always spread to the peritoneal cavity, and serous type often with the highest ca-125, however mucinous type with the lowest.
however,i do not know
she underwent a total abdominal hysterectomy with salpingo-oophorectomy 12 years ago, she do not have ovary , tube and uterus, how can she has ovary cancer?
I immediately echo this last sentence. Id go with answer-f
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| SA
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not having overy means nothing as I had seen cases of overies removed but develop overian cancer.
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| p53
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Correct answer is F. A serous peritoneal carcinoma has gross and microscopic characteristics, as well as immunohistochemical features and serum tumor markers, that are identical to an ovarian serous cystadenocarcinoma, but it is thought to arise from the mesothelium, probably in a multifocal fashion. It is unlikely, even if the patient had a prior ovarian neoplasm, that it lay dormant for 12 years. The risk of serous peritoneal carcinoma is increased in women who have had an ovarian serous cystadenocarcinoma. It is unlikely that a cystadenocarcinoma would recur 12 years later.
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| fleuve
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Is the peritoneal origin Serous peritoneal carcinoma a Malignant mesothelioma ?
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| p53
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No, it isn't. They are different mallignancies. Malignant mesothelioma of peritoneum is caused by azbestos exposure.
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| rubensssss
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I will go for F
B) patien had total abdominal hysterectomy 12 years ago.
D) and E) patien had salpingo-oophorectomy 12 years ago
C) Malignant mesothelioma of peritoneum is caused by azbestos exposure.
A) adenocarcinoma of the colon can be a good answer, if you did not said the answer I would choose letteA),
Do you have the explanation to this question,or is because 1-cm cystic to solid nodules on the surfaces of the bowel and abdominal wall.that means that is not a cystic solid nodule on colon that could be adenocarcinoma.
Thanks for this question is very good.
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