GYN TRIAD
Ovarian Carcinoma with Peritoneal MetastasisAscites is an abdominal accumulation of fluid in the peritoneal cavity, which
usually causes abdominal distention. The etiology of ascites can be
multifactorial and includes heart/kidney/liver disease and ovarian cancer.
In a female patient with ascites, ovarian carcinoma must always be considered.
Although the etiology of ovarian carcinoma is not known, ovulation inhibition,
as occurs with OCPs or pregnancy, does decrease the risk of epithelial ovarian
cancer. Meigs syndrome is the triad of ascites, pleural effusion, and benign
ovarian fibroma.
Lab abnormalities/diagnostic criteria. In a patient with an adnexal mass and
ascites, an abdominal pelvic CT scan should be ordered for evaluation of the
upper abdomen. The most common method of ovarian carcinoma spread is
by peritoneal dissemination (exfoliation) and is commonly seen metastatic to the
omentum and to the GI tract. The cause of death of patients with advanced
ovarian carcinoma is bowel obstruction.
Management.
Postmenopausal bilateral pelvic masses
Weight gain, anorexia
Abdominal “shifting dullness”Surgical staging. After an abdominal pelvic CT scan confirms the presence
of ascites and the adnexal mass, an exploratory laparotomy and surgical