Fast Growing Squamous Cell

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My mother is 72.  On Dec. 14th she had a complete hysterecomy with the fatty underbelly removed due to a mass.  The mass turned out to be Stage I ovarian cancer.  We met with an oncologist 3 weeks after surgery and she was told that they wanted a CT scan of her lungs, but thought she would not need any chemo and was quite lucky.  Two weeks after that appointment she was admitted to the hospital with c-diff.  Long story short, 8 weeks after her original hysterecotomy she had another surgery anticipating a bowel resection and they found 5-7 golf ball sized tumors throughout her bowels of the same squamous cell carncinoma.  She had a ctPET scan and 13 days after surgery and has a 56.5 mm mass and 4-5 clusters of cancer cells in her abdomin, but nowhere else.  On day 14 after surgery, she started chemo.  The oncologists, seem not to be able to provide us with answers, and we are looking for the best regimine to try to gain control of this disease and provide her with a quality of life.  What would be your suggestions?  

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Dr. Goodman:

I am anxious to hear your advice on the pathology information posted on the squamous cell question.

Please let me know if there is any further information that you may need.

Many thanks,

Karen

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Hello Dr.

The pathology report reads:

Designated "pelvic mass", excision:  Squamous cell carcinoma arising from a dermoid cyst
Tumor Location:  right ovary
tumor size:  9 x 4 cm
ovarian surface:  negative for carcinoma
residual ovary:  dermoid cyst
biologic type:  squamous cell carcinoma
Biologic grade:  Grade II, moderately differentiated with extensive necrosis
Falopian tube(s):  Unremarkable
Endometrium:  atrophy and polyp
Myometrium:  Leiomyomata
uterine serosa:  unremarkable
cervix:  nabothian cysts
omebtum/peritoneum:  negative for metastatic carcinoma

(that was as of Dec. 14th surgery)

Jan 4th ca-125 level of 16

Feb 8th surgery for bowel resections
frozen section diagnosis:  metastatic carcinoma consistent with squamous cell type.  Small bowel (a) and Small bowel mesentery (b)

Part a - the specimen consists of pieces of a poorly differentiated tumor composed of medium-sized to large malignant cells demonstrating eosinophilic cytoplasm, pleomorphic nuclei, prominent nucleoli, frequent mitotic activity, and a suggestion of some intercellular bridges focally.  Part B- the specimen consists of a nodule of squamous cell carcinoma demonstrating keratin production and dome dyskeratotic cells.  The tumor is moderately to well differentiated.

As of Feb 22nd CA-125 of 67 and PET scan of Feb 21st showed one mass approx 56 mm and 4 -5 cell clusters in abdominal cavity all else clear.

Any suggestions as the oncologist that we have here has never seen this and it is so very rare that we are searching for sources that may be familiar to assist with treatment options...

Many thanks.....

[Annekathryn Goodman, M.D.]

Hi There,
can you please get a copy of the pathology report and type it in here? It would be very unusual to have a squamous cell cancer of the ovary. Different chemotherapy might be considered for that than the more common adenocarcinoma
best wishes