Case Presentation: Adoption in the Cancer Setting

A 30-year-old woman presented to a referring hospital emergency room with abdominal pain and vaginal bleeding. She worked as a musician and had limited financial security but had medical insurance. Ultrasound was performed, demonstrating lobulated, bilateral ovarian masses with concern for ovarian torsion. Emergency surgery was performed to relieve ovarian torsion, and pathology revealed endometrioid adenocarcinoma of the right ovary and mixed clear-cell and endometrioid carcinoma. Unfortunately, the patient had a complicated postoperative course that included wound dehiscence and infection, delaying further cancer-directed therapy. She required a prolonged hospital stay, including prolonged antibiotics, a wound vac, and eventual discharge to a skilled nursing facility (SNF). She has limited social support, with a sister living locally whom she stayed with after recovering in the SNF. She was in a relationship, but it ended shortly after cancer diagnosis. Following recovery, she was referred to gynecologic oncology for further management where it was recommended she undergo three cycles of neoadjuvant chemotherapy with carboplatin and paclitaxel followed by interval staging/debulking surgery and then an additional three cycles of adjuvant chemotherapy.