Suspected ovarian cancer in a young patient with a congenital heart defect and a history of cardiac surgery and pacemaker implantation – difficult therapeutic decisions

• Authors: Kamila Kaźmierczak , Tomasz Stempniewski , Joanna Kufel-Grabowska , Błażej Nowakowski
• Languages of publication: EN

Abstracts

EN

After uterine cancer, ovarian cancer is the second most common female reproductive tract malignancy. In Poland, in 2015, there were 3735 new cases and 2738 deaths from ovarian cancer. Over 80% of all cases are diagnosed in women aged over 50, whereas only 6% – before 35 years of age. Most cases are diagnosed, when clinical symptoms have already appeared, and the disease is at least locally advanced. The case presented below describes a very young 28-year-old woman with a tumour in the pelvis, ascites and very high Ca 125 and HE 4 levels. The clinical symptoms as well as laboratory and imaging tests were suggestive of epithelial ovarian cancer that required urgent surgery due to progression of the disease. The surgery posed a significant risk of complications, but owing to the deterioration of the patient’s condition it was considered necessary. The patient was born with a severe, complex heart defect, had undergone two cardiac surgeries, and had a pacemaker (first VVIR, then DDD). She was also intensively treated for iatrogenic HCV infection and hypothyroidism. A multidisciplinary team (a gynecologist, cardiologist and anesthetist) were behind the decision to carry out a major gynecological operation which ended with success. For the past 6 years, the patient has been under constant oncological follow-up and enjoys a good health.

Keywords

EN

Ca 125 marker; congenital heart defect; endometriosis; ovarian cancer

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OncoReview
• Year: 2018
• Volume: 8
• Issue: 2
• Pages: 38-41

Contributors

author

Kamila Kaźmierczak

• Greater Poland Centre of Oncology in Poznań

author

Tomasz Stempniewski

• Greater Poland Centre of Oncology in Poznań

author

Joanna Kufel-Grabowska

• Greater Poland Centre of Oncology in Poznań

author

Błażej Nowakowski

• Greater Poland Centre of Oncology in Poznań

References

• 1. Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med 2017; 14: 9-32.
• 2. Krajowy Rejestr Nowotworów [online: http://onkologia.org.pl/raporty/].
• 3. Crijns PG, Boezenb HM, Schouten JP et al. Prognostic factors in ovarian cancer: current evidence and future prospects. Eur J Cancer Supl 2003; 1(6): 127-145.
• 4. Khuri SF, Henderson WG, DePalma RG et al. Participants in the VA National Surgical Quality Improvement Program. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005; 242: 326-241.
• 5. Grupa Robocza Europejskiego Towarzystwa Kardiologicznego (ESC) do spraw leczenia dorosłych pacjentów z wrodzonymi wadami serca: Wytyczne dotyczące leczenia dorosłych pacjentów z wrodzonymi wadami serca (nowa wersja – 2010). Kardiol Pol 2010; 68(supl IX): 639-696.
• 6. Oliveira MAP, Raymundo TS, Soares LC et al. How to Use CA-125 More Effectively in the Diagnosis of Deep Endometriosis. Biomed Res Int 2017; 2017: 9857196.
• 7. Zhuang J, Faggiano P, Li Q et al. Insights into the clinical implications of carbohydrate antigen 125 as a biomarker of heart failure: a meta-analysis and systematic review of published studies. J Cardiovasc Med 2014; 15: 864-872.

• Document Type: article