A 55-year-old female presents with abdominal pain, distension, ascites and dyspnea. Her CA 125 levels are elevated. The most likely diagnosis is:

Ans. is a, i.e. Ca ovaryRef: Jeffcoates 7th/ed, p543; Novaks 15th/ed, p1366* M/c age incidence for primary ovarian neoplasms is 40-60 years, peak age incidence being 55-60 years. Ovarian malignancies generally present with vague symptoms like abdominal pain, dyspepsia, and patient may also experience irregular menses and if pelvic mass compresses the bladder or rectum she may have urinary frequency or constipation.In advanced stages patients have symptoms related to presence of ascites, omental metastasis or bowel metastasis like abdominal distension, dyspnea, bloating, nausea, anorexia or early satiety.In the patient given in the question all these symptoms are present (which could be seen in other cancers as well) plus her Ca 125 levels are raised, which favors the diagnosis of ovarian cancer in her.RememberThe most important sign of epithelial ovarian cancer is the presence of a pelvic mass on physical examination.