Papillary serous cystadenocarcinoma of the stomach, peritoneum and ovary

A previous healthy 60-year-old woman presented to the hospital with an abdominal distention for two months. Physical examination revealed a fixed and non- tender mass over right periumbilical region, measuring about 13 m in diameter. Her serum cancer antigen 125 (CA125) was 3188 U/mL. Computerized tomography (CT) of the abdomen and pelvis demonstrated thickening of wall of gastric antrum with air fluid level (Fig. 1A), huge intraperitoneal (Fig. 1B) and pelvic tumors (Fig. 1C) with heterogeneous calcified psammoma bod- ies. Sono-guided percutaneous biopsy of the peritoneum and endoscopic antral biopsy both revealed papillary serous cystadenocarcinoma. She refused to undergo debulking surgery. A combination chemotherapy with paclitaxel (Taxol®) + platinum (Cisplatin®) was initiated. After completing a course of chemotherapy (six cycles every 21 days), the tumor decreased in size. The follow- up of CA125 showed decreased level : 76 U/mL.