Gross painless transudative ascites in a patient with ovarian cancer

Transudative ascites are a rare entity in cancer which may sometimes make their diagnosis difficult. Here, the authors report an unusual case of transudative ascites in a 50-year-old woman with ovarian cancer. The patient first presented with progressive painless gross transudative ascites for the past five months with no associated nephrotic syndrome or liver cirrhosis, and chylous ascites developed on day 14 of the admission. The ascites were transudate with serum-ascites albumin gradient (SAAG) above 11 g/L. Repeated screening of cancer cells from ascites revealed adenocarcinoma originated from ovary.

Ascites; Transudate; Chylous; Ovarian cancer.

[1] Diaz-Guzman E., Culver D.A., Stoller J.K.: “Transudative chylothorax: Report of two cases and review of the literature”. Lung, 2005, 183, 169.

[2] Cohen M., Petignat P.: “The bright side of ascites in ovarian cancer”. Cell Cycle, 2014, 13, 2319.

[3] Uddin M.S., Hoque M.I., Islam M.B., Uddin M.K., Haq I., Mondol G., Tariquzzaman M.: “Serum-ascites albumin gradient in differential diagnosis of ascites”. Mymensingh Med. J., 2013, 22, 748.

[4] Younas M., Sattar A., Hashim R., Ijaz A., Dilawar M., Manzoor SM., et al.: “Role of serum-ascites albumin gradient in differential diagnosis of ascites”. J. Ayub. Med. Coll. Abbottabad, 2012, 24, 97.

[5] Turkcapar N., Ozyuncu N., Cinar K., Ensari A., Kucuk O., Idilman R., et al.: “A case of systemic lupus erythematosus presenting with protein-losing enteropathy”. Turk. J. Gastroenterol., 2006, 17, 226.

[6] Erfani T., Manolios N., Howe G., Spencer D.: “Acute gross painless transudative ascites in a patient with lupus”. BMJ Case Rep., 2014, 2014, pii: bcr2013201503. doi: 10.1136/bcr-2013-201503.

[7] Boutemy M., Buklow K., Glerant J., Martin F., Jounieaux V.: “Transudative pleural effusions and the ovarian hyperstimulation syndrome”. Rev. Mal. Respir., 2003, 20, 134. [Article in French]

[8] Agarwal N., Kumar S.: “Budd-Chiari syndrome owing to liver hydatid disease: Case report and review of the literature”. Ann. Trop. Paediatr., 2009, 29, 301.

[9] Yamamoto T., Matsuda J., Kadoya H., Namba T., Takeji M., Yamauchi A.: “Azelnidipine-induced chyloperitoneum in a patient with microscopic polyangiitis”. Clin. Exp. Nephrol., 2010, 14, 496.

[10] Ebert E.C., Kierson M., Hagspiel K.D.: “Gastrointestinal and hepatic manifestations of sarcoidosis”. Am. J. Gastroenterol., 2008, 103, 3184.

[11] Sachdev Y., Hall R.: “Effusions into body cavities in hypothy roidism”. Lancet, 1975, 1, 564.

[12] Ismail A.M., Aboul-Enein A.: “The role of lymphatics in the formation of ascites complicating schistosomal hepatic fibrosis”. Lymphology, 1976, 9, 43.

[13] Castro G., Freitas C., Beirao I., Rocha G., Henriques A.C., Cabrita A.: “Chylous ascites in a renal transplant recipient under sirolimus (rapamycin) treatment”. Transplant Proc., 2008, 40, 1756.