Author(s): Amer Hayat Khan*, Andee Dzulkarnaen Zakaria,Syed Azhar Syed Sulaiman, Salleh S. Khairiyah,Muhammad Shahid Iqbal
Malignant ascites is a widespread impediment of advanced cancer but to 20% of all cases of malignant ascites have unknown primary tumours. With the exception of ovarian cancer, the response of the ascites to treatment of the tumor is unsatisfactory and treatment related morbidity is common. The intent of most treatments for malignant ascites should be palliative with diuretics paracentesis were the common approach. A 53 years old, male patients who was admitted with history of abdominal distention for past 3 month associated with altered bowel habit and mucus per rectum and significant loss weight. Patients was diagnosed as malignant ascites with multicentric hepatoma with abdominal lymphodenopathy, lung, liver and vertebral body metastasis and left portal vein thrombosis. Patient was managed with temporary external paracentesis (pigtail catheter) and oral furosemide 40 mg daily and spironolactone 100 mg daily. Although abdominal paracentesis, diuretics and peritoneovenous shunting are commonly used procedures in management of malignant ascites, there are no randomized controlled trials evaluating the efficacy and safety of these therapies.