CASE STUDY OF RECURRENT/METASTATIC OVARIAN CARCINOSARCOMA

Presentation

71 year old female with stage IIIB high grade ovarian malignant mixed mesodermal tumor/carcinosarcoma

S/p TAH+BSO and rectosigmoid tumor resection 01/2011

S/p 6 cycles of adjuvant Carboplatin + Taxol 02/2011 to 06/2011 without recurrence/mets

Abdominal metastasis(liver and gall bladder metastasis) in 02/2013

Managment issues of recurrent disease

Patient felt to be not a suitable candidate for repeat abdominal surgery given extent of liver lesions.

Patient with poor performance status at the time of recurrent disease

What would you do?

At Sarcoma Oncology Center Started continuous infusional Ifosfamide,

1gm/m2/day given 14 days on 14 days off, in 03/2013.

S/p 6 cycles of CIV Ifosfamide 03/2013 to 07/2013 with excellent clinical & radiological response

Minimal toxicities, well-tolerated in this elderly patient.

Radiological Response to CIV Ifosfamide

March 2013 CT Abdomen showing large intra-hepatic metastasis prior to Ifosfamide

Radiological Response to CIV Ifosfamide

July 2013 CT Abdomen showing considerable response of hepatic metastasis

Outcome

S/p exploratory laporotomy with right hepatic lobectomy and resection of 6.5cm & 5.3cm tumors with greater than 95% tumor necrosis on surgical pathology in 08/2013

Patient on surveillance protocol since 11/2013 with no evidence of recurrence/metastasis on most recent follow up scans from 09/2014.