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Unknown caseUnknown caseconferenceconference
May 2008May 2008
 
 
Chief complaint andChief complaint andhistoryhistory
59 year old woman59 year old woman
Worsening abdominal pain, Weight lossWorsening abdominal pain, Weight loss((↓30 lb) past 4 months↓30 lb) past 4 months
Pain: right sided, no radiation, dull,Pain: right sided, no radiation, dull,constant, eating worsens, also nausea,constant, eating worsens, also nausea,vomiting and “bloating”.vomiting and “bloating”.
ROS: Fatigue, loss of appetite, short of ROS: Fatigue, loss of appetite, short of breath, frequent urination, ear pain.breath, frequent urination, ear pain.
Seen in 2003 for pain.Seen in 2003 for pain.
CT showed kidney cystsCT showed kidney cysts
 
 
Exam and testingExam and testing
PAST MEDICAL HISTORY:PAST MEDICAL HISTORY:RefluxRefluxChronic knee painChronic knee painHistory of breast cystHistory of breast cyst
EXAM:EXAM:RUQ tenderness. Liver is palpated at theRUQ tenderness. Liver is palpated at thecostal edge.costal edge.
CT:CT:Complex mass in the left ovary (4.7 x 6.9 xComplex mass in the left ovary (4.7 x 6.9 x4.9 cm)4.9 cm)Left and right kidneys with simple cysts.Left and right kidneys with simple cysts.Liver is “fatty”Liver is “fatty”
U/S: left hypoechoic ovarian mass, no free fluid inU/S: left hypoechoic ovarian mass, no free fluid inpelvis, normal endometriumpelvis, normal endometrium
LABS:LABS:
Hyperlipidemia with LDL of 332, triglycerides 294,Hyperlipidemia with LDL of 332, triglycerides 294,and total cholesterol 410and total cholesterol 410
Microscopic hematuria.Microscopic hematuria.
Proteinuria 3+ on UAProteinuria 3+ on UA
CA-125 was 13 U/mL (0-35)CA-125 was 13 U/mL (0-35)
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