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Spontaneous Regression Of Peritoneal Carcinomatosis In A Borderline Ovarian Tumour

Delotte et al., 2009Ovarian cancer

Delotte, J., Ferron, G., Mery, E., Gladieff, L., & Querleu, D. (2009). spontaneous regression of peritoneal carcinomatosis in a borderline ovarian tumour. European journal of obstetrics, gynecology, and reproductive biology, 142(1), 84–85. https://doi.org/10.1016/j.ejogrb.2008.08.008

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Case Details

Disease Location

Right ovary

Personal Characteristics

26 -year-old female

Clinical Characteristics

Patient underwent laparoscopic exploration for symptoms of abdominal pain this revealed diffuse micro nodular peritoneal carcinomatosis, ascites and a tumor of the right ovary peritoneal and ovarian biopsies revealed a tumor proliferation of papillary architecture, the presence of uni and multistratified tissue, as well as cell abnormalities final diagnosis was borderline papillary and serous tumor of the right ovary with no micro-papillary component and non-invasive diffuse peritoneal carcinomatosis 3 cycles of chemo associating carboplatin and taxol were administered followed by a second look laparotomy no regression was observed and peritoneal cancer index was 21/39 with 11/13 abdominal regions involved infra-gastric omentectomy, splenectomy, lombo-aortic and pelvic lymph node dissection, posterior pelvic exenteration and multiple peritonectomies were performed the resection procedure left multiple millimetric nodules of carcinomatosis on the surface of the small intestine, glisson's capsule and the anterior face of the stomach, the score of completeness of cytoreducction was c1 histology of all removed organs demonstrated an involvement by a borderline ovarian tumor with multiple peritoneal dissemination and 8/46 lymph nodes metastases

Remission Characteristics

3 months later, a laparoscopy preceding a hyperighthermic intraperitoneal chemotherapy found a complete fibrosis of the peritoneum with no evidence of macroscopic tumor residue and the multiple biopsies of the different regions of the abdomen and the peritoneal cytology found no viable tumor elements 2 years following the laparoscopy, the patient shows no clinical, biological, or radiological signs of relapse

Treatment & Mechanisms

Proposed Remission Mechanisms

Likely apoptosis presence of post-surgical macroscopic residue of borderline tumor with peritoneal implants is an element predictive of relapse

Clinical Treatment

3 cycles of chemo associating carboplatin and taxol infra-gastric omentectomy, splenectomy, lombo-aortic and pelvic lymph node dissection, posterior pelvic exenteration and multiple peritonectomies were performed

Non-Clinical Treatment

None reported