Chapter 54 • Malignant ascites is a common complication of cancer. • Malignant ascites accounts for 10% of all cases of ascites. • Malignant ascites most commonly occurs in patients with ovarian cancer, gastrointestinal malignancies, and carcinoma of unknown primary location. • Malignant ascites is rarely life threatening, but occurrence signals advanced cancer. • Monitor the situation if the ascites volume is small and/or asymptomatic. • Consider the patient’s performance status and likelihood of response to systemic therapy in choosing a treatment approach. • Treatment approaches include use of diuretics, drainage or diversion of fluid, or use of intracavitary therapies. • Diagnosis more commonly follows a cancer diagnosis. • The differential diagnosis of pericardial effusion in patients with cancer also includes treatment-related adverse effects such as radiation. • Fluid sampling for cytology is needed for definitive diagnosis but has low sensitivity; a pericardial biopsy may increase sensitivity.
Malignant Effusions
Summary of Key Points
Malignant Ascites
Treatment
Evaluation
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Malignant Effusions
