American Board of Internal Medicine (ABIM) Certification Practice Exam

Women presenting with abdominal carcinomatosis and ascites of unknown primary site should be treated as if they have which type of cancer?

1. Breast cancer

2. Ovarian cancer

3. Endometrial cancer

4. Pancreatic cancer

The correct answer is: Ovarian cancer

Women presenting with abdominal carcinomatosis and ascites of unknown primary site are often treated as if they have ovarian cancer due to the characteristic presentation and the incidence rate of ovarian cancer in this demographic. Abdominal carcinomatosis refers to the widespread distribution of cancer cells in the abdominal cavity, and ascites indicates fluid accumulation often associated with malignancies. Ovarian cancer is frequently encountered in women with advanced disease presenting as both abdominal carcinomatosis and ascites. In cases where the primary tumor is not identified, clinical suspicion for ovarian cancer is high because it is one of the most common gynecological cancers and can present with such symptoms. This treatment approach is informed by the demographic and clinical profile, as well as the necessity to provide timely and appropriate intervention. Furthermore, the urgency to manage the symptoms associated with ascites, such as abdominal discomfort and respiratory issues, further necessitates a presumptive treatment regimen for ovarian cancer while the primary site remains under investigation.