34 female history of two low malignant potential tumors of

Patient

Q: 34 female history of two low malignant potential tumors of both ovary and fallopian tubes. Now focal left back pain and mid left abdominal pain ranging from dull to sharp stabbing at times. Swelling of both legs from knees down over four days was unable to walk. Nausea lasting days at a time. Also sleeping upto 17 hrs per day. Ct in 2012 small left kidney cyst. Ct 2015 slightly larger but benign appearing left renal cortical cyst. No note on size on either ct. Labs mcv 79 fL,sed rate 22mm/hr, glucose after meal 106 mg/dl. Doctor tells me kidney is not the issue and sending me to a gastrointestinlolgist.

Doctor

A:   Hello,
Thanks for the query.

Since there is a history of malignant ovarian and tubal cancer, the symptoms that you have now are not related to the kidneys as said by your doctor. Swelling of lower limbs may be indicative of hypoproteinemia which is seen in malignancy. The abdominal pain and nausea also indicate towards the spread of the malignancy to the pelvis and beyond as well.
We will have to examine you thoroughly. Also consult a gynecologist personally. Investigations like CA 125 and LDH may be needed along with a complete blood count, urine and liver and kidney function tests.
Also, a CT scan and an ultrasound may be needed. A surgery may be needed to identify the secondaries. In case it turns out to be a malignancy, treatment options would be surgery, chemotherapy and radiotherapy depending on the stage and type of the tumor. An ECG and 2D ECHO to check the heart and a chest x-ray also to be done.

Hope this helped.
Regards

Comments / Follow Ups

Patient: Sorry for any confusion. My malignant potential tumors were removed surgically in 2006. Should I still follow up with my gyn?I just feel like I am getting no where when I tell my primary my symptoms. Thank you
Doctor: Hello,
We meant that the tumors can cause recurrences anywhere in the body as you did not mention that they were removed or treated.
Yes, you need to see a gynecologist for your symptoms.It could be a pelvic inflammatory disorder as well. Secondaries can be left behind as seedlings in the body even after tumor excisions which can produce symptoms later.
Hope this helped.

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