PMC3965157_01
Primary pelvic and metastatic splenic tumors prior to and following chemotherapy. (A) Prior to chemotherapy, extensive lesions with vague boundaries were detected in the pelvic cavity and mixed cystic-solid masses were identified in the spleen. Following (B) two and (C) four cycles of chemotherapy, changes occurred in the lesions in the pelvic cavity and spleen. (D) Following six cycles of chemotherapy, the primary pelvic tumor was markedly degraded and the splenic mass gradually became cystic.
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Subsequent abdominal and pelvic computed tomography (CT) scans revealed multiple mixed cystic-solid lesions and abdominal and pelvic cavity effusion, presumably due to an ovarian malignancy and multiple metastatic intraperitoneal tumors (Fig. 1, prior to chemotherapy). Follow-up CT reexamination demonstrated that the lesions had markedly diminished, thus, the therapeutic evaluation was partial remission (PR) (Fig 1).
Postoperative pathological results of the lesions. (A) Ovarian pathology following cytoreductive surgery (H&E staining; magnification, x400). (B) CA-125 expression in ovarian clear cell carcinoma (immunohistochemical staining; magnification, x400). (C) Splenic pathology following splenectomy (H&E staining; magnification, x200). H&E, hematoxylin and eosin; CA-125, cancer antigen-125.
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The immunohistochemical results were positive for CA-125, cytokeratin (CK)7, CK19 and epithelial membrane antigen, but negative for CK20 and CD68 (Fig. 2).