CASE REPORT article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1555038
This article is part of the Research TopicAdvances in New Biomarkers for the Diagnosis and Therapy of Gynaecological TumoursView all 9 articles
Chylothorax in a patient with advanced ovarian cancer: a case report and literature review
Provisionally accepted
- Department of Obstetrics and Gynecology, the Fourth Medical Center of PLA General Hospital, Beijing, China
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We reported a case of advanced ovarian cancer with extensive lymphatic metastasis which lead to chylothorax and then chylous ascites. Combined with the literature review, we try to identify its clinical characteristics. Case description A 64-year-old patient with advanced ovarian cancer relapsed presenting with extensive lymphatic metastasis and right pleural effusion. Thoracentesis was performed. The drainage fluid was milky white appearance with triglyceride levels >1.24 mmol/l (110 mg/dl), a cholesterol <5.18 mmol/l (200 mg/dl) and positive chyle test. Multi-disciplinary team recommended anti-tumor therapy for ovarian cancer and conservative treatment for chylothorax，including strict diet with low fat medium-long chain triglycerides and chest tube insertion with interleukin 2 intrapleural perfusion as pleurodesis agent . The chylothorax was improved significantly with progressively reduced and transparent pleural effusion. But strict diet control affected her quality of life negatively, the patient can not insist. So chylothorax recured, but the chyle produced slowly, thoracentesis was performed repeatedly with IL-2 or cisplatinum pleural perfusion at intervals of 2-5 months (totally 6 times) during March 2021~June 2023. Since June 2023, the patient could not tolerate systemic chemotherapy because of severe myelosuppression after 4 line chemotherapy. The patient developed bilateral chylothorax and then chylous ascites in December 2023. Finally, the patient died in March 2024. Conclusion Ovarian cancer complicated with chylothorax is a rare condition with relatively poor prognosis. Pleural fluid analysis can identify this condition when clinical suspicion exists. Anti-tumor treatment of ovarian cancer and conservative management of chylothorax were firstly recommended instead of surgery, which are proved to be effective to treat OCC.
Keywords: ：Chylothorax, Chylous Ascites, ovarian cancer, diagnosis, Treatment
Received: 03 Jan 2025; Accepted: 09 Sep 2025.
Copyright: © 2025 Wang, Zhang, Niu and Shen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenjie Shen, Department of Obstetrics and Gynecology, the Fourth Medical Center of PLA General Hospital, Beijing, China
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