Chylous ascites following treatment for gynecologic malignancies.
BACKGROUND
Chylous ascites is a rare complication following abdominal radiation or para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options include dietary restriction with addition of medium-chain triglycerides, serial paracenteses, total parenteral nutrition, and somatostatin. Current opinion advocates that surgical exploration and peritoneo-venous shunts be reserved for refractory cases.


METHODS
Two patients developed chylous ascites, one after completion of surgical staging and chemoradiation for stage IIB squamous carcinoma of the cervix and one following para-aortic lymph node dissection for recurrent malignant mixed mullerian tumor of the endometrium. In both cases resolution of the chylous ascites followed placement of a peritoneo-venous shunt.


CONCLUSIONS
Chylous ascites should be considered in the differential diagnosis of ascites in patients with gynecologic malignancy treated with radiation or para-aortic lymph node dissection.
Manolitsas
Tom P
TP
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The James Cancer Hospital and Solove Research Institute, Ohio State University College of Medicine, M-210 Starling Loving, 320 West 10th Avenue, Columbus, OH 43210-1228, USA.
Abdessalam
Shahab
S
Fowler
Jeffrey M
JM
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects; D018200:Mixed Tumor, Mullerian / Q000601:surgery*; D010490:Pericardial Effusion / Q000209:etiology* / Q000601:surgery; D011878:Radiotherapy / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin