Introduction/Background Complete citorreduction continue to be the aim in ovarian cancer treatment. Pleural disease is in some cases a limitation for a surgical approach, malignant pleural effusion is the most common site of stage IV ovarian cancer but the accuracy rate of pleural cytology is low.
Methodology We show through 3 cases the impact of VATS in the management of ovarian cancer with suspicious pleural disease
Results Patient 1, 49 years old, showed in PET TAC a pelvic mass, adenopathies, peritoneal carcinomatosis, pleural effusion and pleural carcinomatosis; an omento biopsy was taken by laparoscopy, aspiration of pleural effusion and biopies were performed by VATS, all of them positive for malignancy, so stage IV ovarian cancer was diagnosed and neoadyuvant chemoterapy started.
Patient 2, 49 years old, showed in PET TAC suspicious right ovary, right pleural effusion, peritoneal carcinomatosis, supra and infradiaphragmatic adenopathies, positive for malignancy pleural fluid citology and inguinal adenopathy, neoadyuvant chemotherapy was started in other centre, histerectomy, doble anexectomy, omentectomy were performed, She came to our center with progressive elevation of CA 125 marker; in diffusion MRI pleural effusion was detected. Diagnostic laparoscopy and VATS showed miliar carcinomatosis in pleura, a biopsy was taken; peritoneal carcinomatosis, a 3 cm nodule in caecum, a 4 cm nodule in diaphfram and multiple adenopathies were resected, complete secondary citorreduction was achieved.
Patient 3, 47 years old, diagnosed with granulosa cell tumor after left anexectomy, 7 years later right ovary tumour and carcinomatosis were seen in TAC, the patient refuse treatment; one year later pleural effusion and multiple milimeter nodules in diaphfram were detected by MRI, negative biopsies for malignancy were obtained by VATS and complete citorreduction was performed.
Conclusion VATS procedure is feasible and can alter the stage and the therapeutic management in advanced ovarian cancer choosing between a surgical or chemotherapy approach
Disclosure Nothing to disclose
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