Case Study: Ovarian Cancer Disguised as Preeclampsia in a Pregnant Woman
Posted: Monday, January 18, 2021
Ovarian cancer may have the ability to imitate the common disorder preeclampsia, based on a Letter to the Editor published in Ultrasound in Obstetrics & Gynecology. Elisa Llurba Olive, MD, of Hospital de la Santa Creu i Sant Pau, Barcelona, and colleagues presented a case of ovarian cancer disguised as preeclampsia in a pregnant woman, featuring the importance of angiogenic factors in arriving at the appropriate diagnosis.
A 33-year-old woman who was pregnant for the first time developed severe, sudden hypertension, increased liver enzymes, and proteinuria at 31 weeks. Ultrasonography, platelet count, and renal profile all appeared to be normal. Severe preeclampsia was diagnosed, and the subject was administered magnesium sulfate, low–molecular-weight heparin, and antihypertensive therapy. Her maternal serum level soluble fms-like tyrosine kinase 1 and placental growth factor ratio was 12, suggesting the diagnosis was not preeclampsia. The patient was discharged after 2 weeks and ordered to follow weekly controls.
Maternal ascites was found in an obstetric ultrasound at 34+6 weeks pregnant. The ovaries were not analyzed, yet a neoplastic disorder was suspected. Preeclampsia could not be ruled out at the time, so the patient was induced and gave birth via cesarean section. Biopsies showed high-grade serous carcinoma, peritoneal carcinomatosis was observed, and blood tumor markers were increased.
The patient underwent complete primary cytoreduction surgery, and specimens showed stage IIIC serous ovarian cancer. After surgery, clinical manifestations subsided, and chemotherapy was administered 3 weeks later.
Ovarian cancer is exceedingly rare during pregnancies and is usually diagnosed at early stages due to routine ultrasonography. However, in this case, abdominal and adnexal malformations were not observed in any sonograms.
Disclosure: The study authors reported no conflicts of interest.
