Case of Fatal Type B Lactic Acidosis in Primary Undifferentiated Ovarian Cancer

Lactic acidosis, characterized by an imbalance between lactic acid production and clearance, presents a significant challenge in the management of critically ill patients.Although commonly attributed to tissue hypo perfusion or hypoxemia (Type A), recent years have witnessed increasing reports of Type B lactic acidosis associated with malignancies, posing diagnostic and therapeutic dilemmas as well as the question of its true prevalence in solid malignancies.We present the first reported case of Type B lactic acidosis with extensive undifferentiated ovarian carcinoma in a 46-year-old female, highlighting the complexities in its diagnosis and management.Despite surgical intervention and supportive care, the patient experienced persistent lactic acidosis, hypoglycemia, and multiorgan dysfunction.Diagnostic considerations included tissue ischemia, sepsis, and the Warburg phenomenon.Management challenges included sepsis with no signs of infection and early chemotherapy initiation amidst critical illness.Ultimately, the patient's deteriorating condition led to a transition to comfort care measures, reflecting the grave prognosis associated with malignancy complicated by Type B lactic acidosis.This case underscores the need for heightened awareness of Type B lactic acidosis in the oncologic setting, emphasizing the importance of early recognition and tailored interventions to optimize patient outcomes.