Grade 3 Mucinous Tumor

Question:  

Please advise on the following case….

14 year old girl. Transverse incision for a complex 20cm cyst, aspirated prior to removal.

Path =G3 mucinous tumour

CT shows necrotic para-aortics up to the renals. Core biopsy of wound ‘haematoma’ positive for cancer.

Not considered operable at this stage

Many thanks, 

Michael Quinn
 

 
Response #1:

Really tough situation.  Any indication of GI type of disease?

Chemo – either FOLFOX Avastin or Carbo/Tax + Avastin.

Stain the tumour for Her 2 and look for other mutations – may be a possible future option.

Good luck.

Amit

Amit M. Oza

 
Response #2:

Hi Michael,

Interesting case at this age. Has the appendix been removed and bowel been examined? 

If bowel is negative and the pathologist is sure it is not a poorly diff germ cell or stromacell tumor, you have the choice between standard chemo for ovarian or bowel. (The Mucinous ov cancer study will give the answer in the future). If she responds well to chemo I would consider intervention debulking.  

Regards,

Ruud

Ruud Bekkers

Nijmegen, the Netherlands

 
Response #3:

Dear Michael,

Terrible story. Do you have any idea from which structure it originates?

Thanks

Jan

Jan B. Vermorken, MD, PhD