Mrs. Ida initially presented with abdominal distension resembling a 5-month pregnancy. Ultrasonography revealed a complex mass occupying the lower abdominal cavity. The challenging nature of the tumor, densely adhered to the intestines and vital pelvic organs, rendered surgical intervention precarious. Additionally, her CA 125 tumor marker levels were markedly elevated, indicating a probable malignancy in late August 2012.
Ida夫人最初出现腹部膨胀,类似5个月的怀孕。超声波检查显示复杂的肿块占据了下腹腔。肿瘤与肠道和重要的盆腔器官紧密粘连,使得手术干预十分困难。此外,她的CA125肿瘤标记物水平明显升高,表明可能是恶性肿瘤,这是在2012年8月下旬。
Given the surgical complexities and adhesions to the intestines and other tissues, it has slim prospects of achieving complete resection, coupled with the anticipated recurrence post-surgery, hence the doctor deemed surgery is infeasible.
鉴于手术的复杂性和对肠道及其他组织的粘连,其完全切除的前景渺茫,再加上预期的术后复发,因此医生认为手术是不可行的。
ECCT as treatment for Ovarian Cancer will aid in detaching the adhesions, facilitating subsequent surgery," Dr. Warsito explained. "Do not fret if your abdomen enlarges rapidly, coupled with a drastic surge in tumor markers," he added. "Within 1-2 months, the abdomen will enlarge rapidly due to the disintegration of malignant cells, transitioning into fluid. However, the necrotic cells cannot be eliminated due to the membrane encasement, prompting the body's immune system to produce immunofluid to target the dead cells, resulting in fluid accumulation within the membrane and 'ballooning' of the tumor," Dr. Warsito elucidated. "Tumor markers will also surge drastically as the disintegrated malignant cells partially exit through the membrane and enter the bloodstream, detectable by the heightened tumor marker levels," Dr. Warsito emphasized.
ECCT将有助于分离粘连,促进随后的手术,” Warsito博士解释道。“如果你的腹部迅速增大,伴随着肿瘤标记物的急剧增加,不要担心,”他补充道。“在1-2个月内,腹部会迅速增大,因为恶性细胞的瓦解,过渡到液体。然而,由于膜包裹,坏死的细胞无法被消除,促使体内免疫系统产生免疫液体,以靶向死细胞,导致膜内液体积聚和肿瘤的“膨胀”,” Warsito博士阐明道。“肿瘤标记物也会急剧增加,因为瓦解的恶性细胞部分通过膜进入血液循环,在标记物水平增高时可检测到,” Warsito博士强调道。
The initial reaction she experienced upon donning the device was abdominal pain, albeit tolerable. She also experienced incessant flatulence of high intensity. Subsequently, she noticed continuous mucous discharge akin to leukorrhea. Profuse sweating ensued, accompanied by dark or black-colored defecation and highly malodorous urine, albeit relatively infrequent.
她第一次戴上装置时的初始反应是腹部疼痛,尽管可以容忍。她还经历了高强度的持续性肠胃气体排出。随后,她注意到持续的类白带的粘液排出。大量出汗,伴随着深色或黑色的排便和气味浓烈的尿液,尽管相对不频繁。
After 2 months of device usage, her abdomen nearly doubled in size. However, the hardness diminished compared to the initial phase, and the lower abdominal pain subsided considerably. These manifestations were in line with Dr. Warsito's initial explanations, albeit Mrs. Ida still experienced distress, perceiving her condition akin to advanced pregnancy. Further exacerbating her distress was the tumor marker test results, soaring over 4-fold from 1107 pre-device usage to 4792 post-2-month usage. Ultrasonography revealed numerous previously solid tumor components transitioning into cystic formations, suggestive of extensive necrosis.
使用装置2个月后,她的腹部几乎增加了一倍大小。然而,与初始阶段相比,硬度降低,下腹部疼痛明显减轻。这些表现与Warsito博士最初的解释一致,尽管Ida夫人仍然感到困扰,认为自己的病情类似于晚期妊娠。进一步加剧了她的困扰的是肿瘤标记物检测结果,从装置使用前的1107升至使用后的4792,增加了4倍以上。超声波检查显示,许多先前的实质性肿瘤成分转变为囊性结构,暗示广泛的坏死。
Mrs. Ida persisted in device usage for another month before undergoing pre-operative MRI. The MRI results depicted a sizable mass exceeding 21x20x16 cm, predominantly cystic, with indications of spinal metastasis, classifying her as stage 4. Surgery is now feasible. "What about the bone metastasis?" Mrs. Ida inquired anxiously. "Resume device usage immediately post-surgery," Dr. Warsito asserted.
Ida夫人在再使用装置一个月后进行了术前核磁共振成像。MRI结果显示一个超过21x20x16厘米的巨大肿块,以囊性为主,表现出脊柱转移的迹象,将其归类为四期。手术现在是可行的。“骨转移呢?”Ida夫人焦虑地问。“手术后立即恢复使用装置,” Warsito博士断言道。
Mrs. Ida complied and subsequently consulted her surgeon. Following review of the MRI findings and clinical examination, the surgeon scheduled her for surgery on January 2, 2013. The surgery proceeded smoothly, devoid of adhesions, enabling complete mass excision, encompassing 5 large and small sacs, totalling 5 kg in weight. Given the clean surgical outcome, chemotherapy was deemed unnecessary by her oncology. Moreover, her MRI post-surgery indicated stage 0, contrasting the initial stage 4 designation based on MRI findings.
Ida夫人遵从了这一建议,随后咨询了她的外科医生。在审查MRI结果和临床检查后,外科医生安排了她在2013年1月2日接受手术。手术进展顺利,没有粘连,完全切除了肿块,包括5个大和小的囊袋,总重5公斤。鉴于手术结果良好,肿瘤学家认为不需要化疗。此外,她术后的MRI显示为零期,与MRI结果中的初始四期相对。
Post-operatively, Mrs. Ida continued using the ECCT device to eradicate residual cells and address potential bone metastasis. Following surgery, Mrs. Ida resumed her normal activities, experiencing a semblance of normalcy. She attained remission within 6 months of her initial ovarian cancer diagnosis, with a combined therapeutic approach comprising ECCT usage, followed by surgery, and subsequent prophylactic device usage. Mrs. Ida continued device usage for preventive purposes for 5 years, with a 2017 CT scan revealing no recurrence or metastasis.
手术后,Ida夫人继续使用ECCT装置清除残余细胞并处理潜在的骨转移。手术后,Ida夫人恢复了正常活动,体验到了一种正常状态。在她最初被诊断患有卵巢癌的6个月内,她实现了缓解,采用了ECCT使用,随后进行了手术,并随后进行了预防性装置使用。Ida夫人持续使用预防性装置5年,2017年的CT扫描显示没有复发或转移。
In early 2024, marking her 11 years of survival since achieving remission, epitomizes the amalgamation of innovative technology, surgical intervention, and patient perseverance in triumphing over formidable odds, paving the way for enhanced therapeutic modalities and improved patient outcomes in the realm of oncology.
2024年初,标志着她获得缓解后生存了11年,象征着创新技术、手术干预和患者毅力的结合在克服严峻挑战方面取得了成功,为肿瘤学领域的增强治疗模式和改善患者预后铺平了道路。
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