Cytologically Yours: CoW: 20140120

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Contents

Clinical Summary

The patient is a 46 year old female with a new pleural effusion, pelvic mass, and ascites. She presented to the ED with increasing abdominal distension and discomfort. She also has nausea and has been unable to tolerate anything by mouth. She has shortness of breath and has had a recent >20lb weight loss in the last two months.

Past Medical History

  • Hyperlipidemia
  • Coronary artery disease
  • Hepatitis C

Past Surgical History

  • Cardiac stent (2011)
  • Exploratory pelvic surgery

CT

  • Ascites
  • Left hydronephrosis
  • enlarged uterus 12 x 7 x 7 cm.
  • 13 cm pelvic mass
  • Right sided pleural effusion

Clinical Plan

Therapeutic paracentesis.

Pathology

Cytology


Resident Questions


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Final Diagnosis

Cytology

  • Adenocarcinoma.

Surgical Pathology

  • Metastatic adenocarcinoma, consistent tiwht papillary serous carcinoma.

Discussion

Serous adenocarcinoma commoly presents with widespread peritoneal metastases. Microscopically the tumor can be papillary, solid or nested. Psammoma bodies may be present.