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© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

Budd–Chiari syndrome (BCS) is a rare condition, usually associated with hematological disorders such as thrombotic diathesis and hypercoagulability. Serum CA-125 level is an established tumor marker of ovarian malignancy; however, cases of primary BCS may also show raised CA-125 levels. BCS in a case of ovarian carcinoma is usually primary in nature due to hypercoagulable state, and raised CA-125 levels with tender hepatomegaly in a treated case of ovarian carcinoma usually imply metastatic recurrence in the liver. However, our case demonstrates an atypical secondary cause of BCS in such a patient caused by extrinsic compression of IVC due to recurrent disease.

Case presentation

We report an unusual case of a 69-year-old female who presented with nausea and abdominal pain. She had a 7-year-old history of endometrioid carcinoma of the right ovary for which she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic lymph node dissection along with adjuvant chemotherapy. Currently, she had right hypochondrium tenderness, deranged liver function tests (LFT) and raised CA-125 levels, which raised suspicion of hepatic metastasis. However, CECT abdomen revealed peripheral mottled enhancement of liver with multifocal extrahepatic tumor deposits, one of them causing compression of inferior vena cava (IVC) implying a diagnosis of secondary Budd–Chiari syndrome.

Conclusions

In a background of treated ovarian malignancy with raised CA-125 levels and deranged LFT, primary suspicion is of hepatic tumor recurrence. However, in our case, radiological investigation revealed diagnosis of secondary Budd–Chiari syndrome due to perihepatic metastatic recurrence with the absence of frank intrahepatic lesions.

Details

Title
Rare presentation of recurrent ovarian carcinoma with secondary Budd–Chiari syndrome: a case report
Author
Damini, S. 1   VIAFID ORCID Logo  ; Chandrashekhara, S. H. 1 ; Ray, M. D. 2 

 All India Institute of Medical Sciences, Department of Radiodiagnosis, New Delhi, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103) 
 All India Institute of Medical Sciences, Surgical Oncology, IRCH, New Delhi, India (GRID:grid.413618.9) (ISNI:0000 0004 1767 6103) 
Pages
129
Publication year
2024
Publication date
Dec 2024
Publisher
Springer Nature B.V.
ISSN
0378603X
e-ISSN
20904762
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3074237082
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.