Trismus and diffuse polymyalgia: an unusual presentation of recurrent metastatic ovarian cancer.
A 22-year-old woman first presented in 2009 with abdominal distention. The diagnosis of stage IA right ovarian tumour was made by fertility-sparing surgery. In the subsequent years, the involvement of the left ovary and metastasis to the lungs prompted further surgical intervention and chemotherapy. By 2013, she experienced insidious, debilitating and diffuse musculoskeletal pain with trismus. Polymyositis or diffuse radiculitis was suspected. Imaging studies identified enhancing lesions in the thigh musculature, temporalis, parotid gland, pterygoid, masseter, tongue, cerebellum and leptomeninges. Biopsy of one of the thigh lesions confirmed the diagnosis of mucinous adenocarcinoma. She succumbed to the disease in November 2013. This case illustrates the aggressive nature of mucinous epithelial ovarian cancer and its resilience to conventional chemotherapy. On account of its high death rate, it is recommended that the epithelial-mesenchymal transition be researched and early therapy targeted at the k-ras oncogene initiated in spite of the tumour's lower initial staging.
Department of Neurology, City of Hope, Duarte, California, USA.
Ramsis
R
Benjamin
Department of Pathology, City of Hope, Duarte, California, USA.
Jing
J
Zhai
Department of Medical Oncology, City of Hope, Duarte, California, USA.
Robert
R
Morgan
Department of Neurology, City of Hope, Duarte, California, USA.
Neal
N
Prakash
D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000473:pathology*; D000328:Adult; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D019042:Muscle Neoplasms / Q000556:secondary*; D018482:Muscle, Skeletal / Q000473:pathology; D063806:Myalgia / Q000209:etiology*; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000473:pathology* / Q000628:therapy; D009375:Neoplasms, Glandular and Epithelial / Q000150:complications / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology*; D010053:Ovary / Q000473:pathology*; D013848:Thigh / Q000473:pathology; D014313:Trismus / Q000209:etiology*; D055815:Young Adult