Take home pearls from the case:
- Stage IV disease is defined as having one of the following: malignant pleural effusion, parenchymal metastases (not just on surface of intestines, omentum, etc) or mets to extra-abdominal organs or lymph nodes
o Ovarian cancer treatment updates hot off the presses – after cytoreductive surgery, intraperitoneal chemo with IV chemo for stage III ovarian cancer can improve survival significantly, but <50% of patients actually receive this! http://jco.ascopubs.org/content/early/2015/08/03/JCO.2015.61.4776
- The underlying malignancies associated with dermatomyositis vary by prevalence of certain cancers in specific populations (for example, nasopharyngeal carcinoma in highly associated in Southeast Asian patients, but not in other parts of the world). However, adenocarcinomas of the lung, cervix, ovaries, pancreas and bladder account for over 2/3 of the associated cancers, and some studies suggest ovarian cancer has an even stronger association.
- Ovarian cancer is associated with a wide variety of paraneoplastic syndromes involving nearly all organ systems, and DIC is among these associated syndromes.
- Solid tumors generally have a very low risk of tumor lysis syndrome, and this is even less likely to develop after the patient has undergone cycles of chemotherapy
Cairo MS, Coiffier B, Reiter A, et al. Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol 2010; 149:578.