Case of Ovarian Carcinosarcoma caused by Tamoxifen Use for Breast Cancer
A 53-year-old woman presented with complaints of lower abdominal pain, bloating and increased frequency of urination. Examination of the patient revealed oedema in her legs. Additionally, the doctors performed a pelvic exam which was significant for ascites and a mass in the pelvic region, measuring 15 cm. Moreover, she had a history of breast cancer which was diagnosed 12 years back. Her family history of breast cancer was also positive as her mother and a second-degree relative had been diagnosed with it previously.
Investigations
The doctors ordered a pelvic Ultrasound and MRI which showed a large pelvic cystic mass and peritoneal thickening. The peritoneal findings were highly suggestive of metastasis.
Management of Previously Diagnosed Breast Cancer
The woman had undergone a lumpectomy after her initial diagnosis. Furthermore, the doctors performed a modified radical mastectomy after the recurrence of her breast cancer. Additionally, the doctors prescribed her Tamoxifen which she was taking for the past 8 years.
Ovarian cancer: Treatment and Biopsy
Prior to the treatment of her ovarian cancer, the doctors performed an explorative laparotomy to confirm the patient’s diagnosis. They found bilateral ovarian cysts and peritoneal metastasis in the pelvis and abdomen.
Therefore, the doctors performed a total abdominal hysterectomy along with bilateral salpingo-oophorectomy. They also removed the omentum.
The biopsy of the removed ovaries and fallopian tubes confirmed the diagnosis of ovarian carcinosarcoma. Moreover, the uterus demonstrated atrophy with atypia, which confirmed the metastasis of ovarian cancer to the uterus.
The doctors told the patient to start chemotherapy but she refused treatment. Subsequently, she presented to the emergency again with alarming symptoms. The doctors treated her with Paclitaxel and Carboplatin chemotherapy drugs after which she gave the consent to continue with this treatment.
