title: Evaluating patients with mildly elevated transaminase levels.
abstract: S.B. is a 52-year-old woman with recurrent stage IV ovarian cancer. She initially presented three and a half years ago with complaints of abdominal pain, increased abdominal girth, and abdominal bloating. A CA-125 blood test was elevated, and a computed tomography scan of the abdomen and pelvis revealed bilateral ovarian masses highly suspicious for malignancy. She was taken to surgery for a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and suboptimal tumor reduction. Pathology revealed poorly differentiated papillary serous ovarian cancer. Metastatic disease was noted in the rectosigmoid area and vaginal apex. Postoperatively, she received six cycles of paclitaxel and carboplatin. At completion, her CA-125 normalized and imaging studies showed no evidence of disease. However, within three months, her CA-125 was elevated and a palpable mass at the vaginal apex was proven by biopsy to be recurrent disease.
authors.affiliation: Laura Lee Blanton Gynecologic Oncology Center, University of Texas M.D. Anderson Cancer Center, Houston, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Burns
authors.forename: Shiney
authors.initials: S
authors.lastname: Kurian
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Burke
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001219:Aspartate Aminotransferases / Q000097:blood*; D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood; D015984:Causality; D017024:Chemotherapy, Adjuvant; D018292:Cystadenoma, Papillary / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008111:Liver Function Tests; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000628:therapy; D010052:Ovariectomy; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000556:secondary; D012680:Sensitivity and Specificity; D012811:Sigmoid Neoplasms / Q000175:diagnosis / Q000556:secondary; D014057:Tomography, X-Ray Computed; D014625:Vaginal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000556:secondary
chemical_list: D000970:Antineoplastic Agents; D018394:CA-125 Antigen; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase