Initially attributing her pain to premenopausal hormonal changes, Thuy sought medical attention when her abdomen began to swell. Doctor Huynh Ngoc Thu Tra, from the Obstetrics and Gynecology Center at Tam Anh General Hospital in TP HCM, discovered a 48x55x47 mm ovarian mass and hundreds of small nodules scattered across Thuy's peritoneum (the membrane lining the abdominal cavity). The fatty tissue in her abdomen showed signs of infiltration, edema, congestion, and structural disruption. A biopsy of a 3-5 mm tissue sample confirmed ovarian cancer with peritoneal metastasis.

Doctors held a consultation to determine the optimal treatment plan for Thuy, which includes surgery, systemic and localized chemotherapy, and management of ascites.

Doctor Thu Tra (left) and Doctor My Nhi (middle) performing a laparoscopy to obtain a biopsy sample from Thuy. Photo: Tue Diem

Doctor Thu Tra (left) and Doctor My Nhi (middle) performing a laparoscopy to obtain a biopsy sample from Thuy. Photo: Tue Diem

Ovarian cancer with peritoneal metastasis occurs when cancer cells spread from the ovaries to the peritoneum. This advanced form of cancer is often diagnosed late due to its initially vague symptoms, which can be mistaken for digestive issues or hormonal imbalances.

According to Doctor Tra, most peritoneal metastases originate from primary cancers within the abdominal cavity. Cancers originating outside the abdomen account for about 10% of peritoneal metastases, primarily from breast cancer, lung cancer, and melanoma. Common symptoms include bloating, abdominal distension, pelvic pain, early satiety, weight loss, loss of appetite, and sometimes persistent indigestion. These symptoms are often overlooked, especially in premenopausal women who may attribute them to age-related changes or weight gain. Some patients are only diagnosed when they experience significant abdominal distension, fluid accumulation, or bowel obstruction.

Ovarian cancer encompasses a group of malignancies originating in the ovaries, fallopian tubes, or peritoneum. The American Cancer Society identifies 4 early symptoms that are often ignored: bloating, pelvic pain or pressure, early satiety, and frequent urination.

Pelvic pain is often dull and may resemble menstrual cramps. It can be localized or widespread and is frequently accompanied by bloating and mild indigestion. These symptoms typically persist and worsen over time, easily confused with digestive problems, hormonal fluctuations, or menopausal symptoms. Women 40 and older, especially those who have reached menopause, should seek medical attention if they experience these symptoms.

Tue Diem

*The patient's name has been changed.