Background: A 47-year-old woman with a history of ovarian cancer and a 6-year disease-free remission presented with dyspnea and increased abdominal girth. The patient was found to have ascites and a large left pleural effusion, both of which contained malignant cells consistent with recurrent ovarian cancer. Her disease progressed despite treatment with chemotherapeutic and hormonal agents. She was then enrolled in a phase I clinical trial of adenoviral-mediated interferon β gene therapy. Investigations: Abdominal and chest CT scans, 2-[18F]fluoro- 2-deoxyglucose PET scan, viral cultures, interferon cytokine analysis, immunophenotyping, and tumor cytotoxicity analyses. Diagnosis: Stage IV ovarian cancer with malignant ascites and pleural effusion. Management: Tunneled pleural catheter and intrapleural adenoviral-mediated interferon β gene therapy.
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