A FEMALE WITH MALIGNANT ASCITES: A DIFFICULT CASE WITH CARCINOMA OF UNKNOWN PRIMARY

Abstract

Malignant ascites is the abnormal accumulation of !uid in the peritoneal cavity associated with several intra-pelvic
and intra-abdominal malignancies. Among the gynecologic malignancies, ovarian carcinoma predominates. Of the
gastrointestinal malignancies, ascites can occur with advanced colon, pancreas, gastric carcinoma, and esophageal
carcinoma. Recent reports in the cytological literature suggest that 6% to 11% of malignant peritoneal effusions are
due to tumors of unknown origin.1 We reported a 62 years old female presenting adenocarcinoma ascites, which shown
confusing of site of primary origin from imaging examination. First ultrasound imaging showed mass on colon area, but
re ultrasound of abdominal imaging showed the possibility of endometrium carcinoma. The CA 125 level was high (2.294
u/ml). Open laparotomy showed milliar metastatic several nodule on omental, liver, and abdominal wall. There was
attachment of vesica urinaria, endometrium, colon, sigmoid, and rectum. All those result conclude this patient suffered
from malignant ascites of adenocarcinoma of unknown primary origin, with highly suggestive from malignant ascites of
adenocarcinoma of unknown primary origin, with highly suggestive from gynecologic malignancy that difcult to differ
whether from ovarian cancer or endometrium cancer. Somehow, the epidemiology, pathophysiology, clinical presentation
lead the diagnosis for ovarian cancer.