Ovarian Cancer Management in the Pandemic Era: Does it make a difference?

Written by:  Sara Nasser Gynecological Oncology Fellow, Berlin-Germany & Moiad Alazzam Consultant Gynaecological Oncology Surgeon, Oxford-UK

Clinical History & Examination

Presenting history:

Mrs. B, a 61 year old lady, presents with a 4 week history of abdominal discomfort and bloating. She lost 4 Kgs in the last month and has had reduced appetite.

She has also noticed an increased shortness of breath on exertion for the  week prior to admission .

Mrs. B has mild asthma and no other relevant comorbidities.

She has not been to the gynaecologist and hasnt attended cervical screening for over 5 years as her daughter has been unwell and she has had to look after her.

Past surgical history:

  • Total Abdominal Hysterectomy due to uterine Fibroid 10 years ago.
  • Appendectomy as a child

On Examination:

  • Abdomen distended, non-tender.
  • Speculum: No abnormalities

Ultrasoound:

Minimal free fluid in the pelvis, 60x50mm solid tutor formation at the vaginal vault with increased Doppler perfusion.

Investigations

Biomarkers:

  • CA-125: 894
  • CEA and CA19-9 within normal
  • SARS CoV2 Test: Positive ( Tested 4 days prior to admission)  

Imaging

  • CT Scan Thorax: No abnormalities detected
  • CT Scan Abdomen/Pelvis: 60×50 Tumor at vaginal vault, peritoneal carcinomas and omental cake

 

Q1: How would you proceed with the management of this lady considering her COVID Status?