An atypical presentation of advanced-stage ovarian cancer: Is there value in routine screening?

As contemporary practice guidelines stand, the use of screening tools and confirmatory diagnostic testing for ovarian cancer is utterly reliant on clinical suspicion. Clinicians must consider symptomatology and risk factors in an effort to subjectively determine which of their patients requires ovarian cancer screening. Because disease risk factors are well-established, patients at elevated risk are routinely screened. However, in the case of a patient at average risk, clinical presentation becomes the key determinant in the decision to screen. Such symptoms, unfortunately, lack both sensitivity and specificity for ovarian cancer. The case elucidated in this manuscript provides an example of how clinical presentation alone is not a reliable predictor of ovarian cancer diagnosis, suggesting that there is value in routine screening. We present the case of a 43-year-old Female with diffuse abdominal pain, nausea, vomiting, and constipation. She did not present with weight loss, early satiety, abdominal bloating or any other symptoms proven to be independently associated with ovarian cancer. Had she been screened for disease at an earlier date, it is reasonable to assume that her tumor would have been caught early on, leaving her with a more favorable prognosis.