A 38-year-old woman with a 3-year history of abdominal cramps, bloating, and constipation.
Physical examination revealed abdomen with displaceable dullness.
Cal25 of 354 (U/ml), CEA 4.3 (Ul/ml).
The rest of the laboratory tests were normal.
Abdominal computed axial tomography (CAT) showed a right adnexal mass involving the cecal pole and the presence of peritoneal carcinomatosis.
The apex located at the cecal pole showed a proliferative, exophytic and irregular lesion of 4 cm long axis.
The biopsy concluded villous adenoma with severe dysplasia.
Upper endoscopy was normal.
Paracentesis was performed and the cell block confirmed the presence of carcinoma.
Culture of tumor cells of ascites and study of response to chemotherapy according to the panel used for CO, as planned.
Under the clinical suspicion of stage III-C OC, chemotherapy was initiated with cisplatin-paclitaxel without response.
She was admitted to hospital with vellous adenoma and intense dysplasia.
Immunohistochemistry (IHC) of the cell block showed intestinal origin: CDX2 positive, Cal25 negative, cytokeratins negative.
A QMT response study was repeated in the in vitro assay to the new cell block using a QMT panel for digestive cancer.
QMT was changed to FOLFOX regimen.
He died with rapid clinical deterioration.
QS analysis for CO panel showed cisplatin-paclitaxel cytotoxicity below 30%.
The QS study for progression to digestive cancer panel showed cytotoxicity of 20% to FOLFOX scheme.
These results show a correlation between the clinical response and the in vitro test result for both the first and second line of CMT.
