Patient Medical Report

FOR NEOADJUVANT IMATINIB 400mg *1

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There are heterogeneously enhancing and diffusion restrictive soft tissue intensity lesions seen at the site of both ovaries, enclose contact with the uterine wall, along with enhancing and diffusion restrictive diffuse soft tissue thickening involving the momentum with multiple peritoneal soft tissue deposits The urinary bladder is outlined smoothly. The rectum appears normal.

Appearances are mostly consistent with ovarian tumors with diffuse omental metastasis.

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About 12mm well-defined hyperintense on T2 weighted images lesion seen in the segment VII of the liver which showed early enhancement on arterial phase and became isodense on the venous and delayed images without restriction on the DWI/ADC map suggesting flash filling hasmangiom. In addition, there is about 7mm hyperintense on T2 weighted images segment V lesion which could bot be assessed probably on postcontrast image due to artifact that likely representing haemangioma, however, correlation with U/S is advised. Right small perihepatic enhancing area which likely representing peritoneal deposit. Diffuse oedematous enhancing thickened omentum suggesting omental caking with multiple enhancing nodules.

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No ovarian mass detected by ultrasound scan to be targeted by ultrasound guided biopsy.

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Stomach: Pan gastropathy

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Caecum: 2 superficial tiny apthus ulcers. Bx taken

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An enhancing peri-heptic lesion with adjacent low attenuation area within the likely representing omental deposit with possible liver invasion. Otherwise, no CT evidence of focal liver lesion. Diffuse enhancing omental lesions, suggesting omental caking. The pancreas, both adrenal glands and both kidneys are grossly unremarkable. No significant intra-abdominal free fluid. 6 x 7 cm isodense to the omental caking mass seen in the right side of the pelvis with small central gas locules, this mass could represent the patient’s known ovarian tumour with possible invasion of the adjacent bowel, proper evaluation by pelvic MRI is advised.

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OMENTAL BX: Gastrointestinal stromal tumor C-Kit, Dog1, SMA, Cd34: positive Desmin, S100: negative

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Can be role for neoadjuvant radiotherapy If no response imatinib after 3 months

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Imatinib 400mg

Imatinib 400mg ×1 for 3 months The reevaluation for clresectability