METASTASIS

A female 42 yrs old reported with c/o swelling Left inguinal region for 10 days. No history of Fever, local trauma, cough or swelling on any other part of body. No significant menstrual history. She has mild pain over the swelling. She was put on Augmentin 625 mg twice daily along with NSAID and advised to undergo FNAC. FNAC report along with USG abdomen enclosed. Kindly suggest further investigations/ management n probable prognosis of this case. She is a mother of 2 children and today only revealed that her mother n sister died of some cancer. Regards

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As per the history seems to be case of inguina lymphadenopathy along with para aortic lymph node involvement and maybe adue to metastasis secondary to ovarian malignancy supported by USG and FNAC USG report there are multiple cystic lesions on post myometrium of uterus may malignancy of uterus CT scan of abdomen to see the staging and treatment according to CT report.Get investigation done boold for CA 125 LFT and Kidney function test.

Thanks Dr Bipun Bihari Jain
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Looks like a case of OVARIAN CARCINOMA with uterine and inginal and para- aortic lymph node metastasis.. OR a PRIMARY UTERINE MALIGNANCY with metastasis. A CECT SCAN ABDOMEN AND A PET SCAN IS recommended for the staging and treatment. Also get CA 125 , KFT LFT CBC done As per the presentation- it is a metastatic disease where only chemotherapy is possible

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Likely to be a case of ovarian ca metastizing to the parts of uterus and para aortic lymph nodes... Invstgtn- CECT W/A wth PET SCAN Along with Ca 125 , LDH, Mngmnt - surgery (hysterosalpingoophorectomy) Followed by 6 cycles chemotherapy with ( paclitaxel and cisplatin ) Staging to be done during surgery... Thanku sir for the case

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Panhysterectomy to be done, followed by histopathology. Further as per reports

Thanks Dr. Tirthanker Mukherjee
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Malignancy with Metastasis adv surgery chemotherapy

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Before embarking on any urgent panic measures keep cool. Do core needle biopsy of the lesion and ascertain exact histopathology and IHC markers staging work up can be done with CE/CT and PET scans after obtaining full information decide the treatment protocol. At this stage it is immature to decide any treatment protocol and communication of treatment protocol to the patient.

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1. Do biopsy with IHC from left inguinal node to confirm metastasis. If inconclusive than consider ct guided biopsy of para aortic node. 2. CA-125 levels. 3. Good Per vaginal and per rectal examination. 4. PETCT scan if can afford or else CT Thorax abdo pelvis.

Evaluate by pelvic examination CECT abdomen and pelvis or whole body pet ct scan CA 125 LFT Surgical staging is required based on imaging Followed by chemotherapy

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Usg suggest neoplastic lesion uterus with metastasis lt inguinal lymphadenopathy Likely Leomyoma which is malignant Adv further workout

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Thanks for sharing

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