unknown primary , ovarian malignancy with mets to the liver, lung , rectum

unknown primary

1. 53 Yrs / F With no known comorbities , presented to Gynae OPD with chief complains of Lower abdominal pain x 3 weeks Loss of appetite x 3 weeks Loose stool with mucus discharge x 10-12 days She also gives history of unintentional weight loss averaging of 6-7 kgs in past 1 year

2. USG- 2024/12/23

3. CECT A+P – 2024/12/27 A ill defined heterogenously enhancing solid cystic mass in pelvis infiltrating the uterus and right lateral wall of rectum, laterally compressing the right distal ureter causing moderate hydroureteronephrosis with non visualization of B/L ovaries sepearately likely ovarian malignant neoplasm Few heterogenously enhancing hypodense soft tissue density lesions of varying sizes in both lobe of liver – likely metastasis Heterogenously enhancing irregular soft tissue density mass with non enhancing necrotic areas in omentum in umbilical region abutting anteriorly abdominal wall and posteriorly abutting small bowel loops – likely metastasis

4. CECT CHEST AND A+P – 2024/12/27 Few heterogenously enhancing aorto-caval and para -aortic lymph nodes – likely metastatic lymph nodes Minimal fluid in pelvis IN CHEST : Multiple solid nodules, some pleural based , some fissural based of variable sized in visualized B/L lung – likely metastasis

5. COLONOSCOPY – 2025/01/02

6. HPE( omental biopsy)-2025/01/07

7. HPE(upper rectum)-2025/01/07

8. IHC- 2025/09/10

9. TUMOR MARERS 2024/12/26 2025/09/03 CA-125 836 0.6 CA 19.9 1.57 7.22 CEA 5.54 2.49

10. TREATMENT HISTORY She completed 6 cycles of 3 weekly Carboplatin / Paclitaxel

11. THANK YOU