Case presentation
A 56-year-old female visited a doctor on October 23, 2013 due to chest
tightness and cough. Chest X-ray examination showed right pleural
effusion and parallel puncture. A small number of cancer cells were
found in pleural fluid smear, which tended to adenocarcinoma. Blood
Ca125>600 IU/ml. Abdominal CT on October 29, 2013 showed
cystic and solid mass in bilateral adnexal areas of pelvis, which was
considered to be derived from ovarian malignant tumor with possible
large peritoneal metastasis. A large amount of pelvic effusion was
considered metastatic. 1 course of intravenous chemotherapy TC regimen
(Paclitaxel 210mg+ carboplatin 500mg). PET/CT examination on November 4,
2013 showed bilateral ovarian MT with multiple metastases to mesentery
and pelvic floor peritoneum, and massive effusion in right pleural
cavity and abdominal pelvis. On November 22, 2013, total hysterectomy +
omentectomy + diaphragmatic incision + pleural exploration +
diaphragmatic repair was performed. Postoperative pathology: (left
ovary) serous papillary adenocarcinoma, high grade, tumor size 8*7*7cm,
left fallopian tube not involved,(right ovary) serous papillary
adenocarcinoma, high grade, tumor size 6.5*5* 2.5 cm, right fallopian
tube not involved, send another (Upper abdominal tumor, left pararectal
tumor, right pararectal tumor) See cancer involvement. Send separately
(liver surface nodule, uterus rectal fossa peritoneum, left ovarian
blood vessel, greater omentum) No cancer involvement;(uterus)
endometrium showed proliferation-like morphology;(cervix) chronic
inflammation. Tumor cells: ER(+++) PR(-) P53(++) Her2/neu(1+) VEGF(++)
WT1(+) β-Catenin(++) Ki67(+)60% Bcl-2(+) bax(+) MDR(+)
TOPOII(individual +) GSTn(+) P27(++) CyclinD1(+) AgNOR1-3/The patients
voluntarily enrolled in the phase II clinical trial of intraperitoneal
chemotherapy for advanced epithelial ovarian cancer, and were randomly
assigned to intraperitoneal chemotherapy group, who received 4 times of
thoracic intraperitoneal infusion chemotherapy from November 27, 2013 to
December 18, 2013, respectively. The regimen: cisplatin combined with
etoposide. The chemotherapy process was smooth. After chemotherapy, III
degree bone marrow suppression occurred. After the last chemotherapy,
blood Ca125: 6.86IU/ml.
The patient received postoperative adjuvant chemotherapy from January 2,
2014 to May 9, 2014, totaling 6 courses (Docetaxel 80mg+ carboplatin
600mg,ivgtt, q3w). From December 2016 to July 2021, traditional Chinese
medicine was given in our department for anti-recurrence and metastasis
treatment, and traditional Chinese medicine intravenous injection: Aidi
injection was given.(Guizhou Yibai Pharmaceutical Co.Ltd, Chinese
medicine approval number: Z52020236)100ml+ compound Sophora flavescens
injection (Shanxi Zhendong Pharmaceutical Co.Ltd, Chinese medicine
approval number: Z140021230)20ml,qd,regular reexamination showed no
evidence of recurrence and metastasis.
On July 8, 2021, PET/CT reexamination showed soft tissue nodules near
the blood vessels in the left pelvic wall and increased FDG metabolism.
It was considered that the metastatic tumor might be large (about 11 mm
x 9 mm x 10mm)(a).The rest showed no abnormality. Blood: Ca125: 4.23
U/ml. From July 16, 2021 to October 18,2021,5 courses of first-line TC
chemotherapy (albumin paclitaxel 200mg d1, d8+ carboplatin 500 mg d1
ivgtt, q3w) combined with traditional Chinese medicine injection: Aidi
injection 100ml+ Kushen injection 20 ml, qd. On September 16,
2021,pelvic MR was evaluated as CR after 3 courses of
chemotherapy(b),Blood: Ca125: 4.23 U/ml. Grade III bone marrow
suppression and liver dysfunction occurred after chemotherapy, so the
sixth course of chemotherapy was suspended, and the efficacy evaluation
during the reexamination was CR. From October 15,2021 to October 30,
2023,the patient continued to receive a total of 10 courses of
traditional Chinese medicine antitumor therapy (Aidi 100ml+ Kushen
Injection 20ml qd), and the reexamination evaluation during the period
was CR(c).The last review was October 31,2023.The imaging examination of
our hospital was CR(d),blood Ca125:10.1U/ml.