Pathwork Diagnostics

Initial presentation:
A 75-year-old non-smoking woman presents with dyspnea and is found to have a large right pleural effusion.

Work up:

Initial treatment:
Carboplatin and paclitaxel recommended; patient and family refused treatment until definitive diagnosis was available.

Pathwork® Tissue of Origin Test ordered.

Results - Tissue of Origin Test:
Interpretation from Pathwork Diagnostics’ pathologist: “The Tissue of Origin Test indicates an Ovarian origin in this case with high probability. However, it should be noted that the current Tissue of Origin Test does not include tumors of endometrial origin and that Endometrial cancers, when run on the Tissue of Origin Test, have been shown to have very high Ovarian signatures…the test has effectively ruled out an origin from 12 other tissues on the panel…Similarity Scores below 5 indicate a greater than 99% probability of that tissue not being the tissue of origin.”

Post Tissue of Origin Test:

• After the results of the Pathwork Tissue of Origin Test, pathology on a pleural biopsy confirmed spread from an ovarian primary.
• With a definitive diagnosis, the patient agreed to treatment with paclitaxel and carboplatin. After two cycles, the patient’s CA 125 decreased, and interval scans showed no new disease and improvement in the right pleural effusion and lymphadenopathy.

“It was frustrating for my patient, my patient’s family, and myself to run so many tests and yet be so uncertain about the source of her cancer. The Pathwork Tissue of Origin Test gave us the definitive diagnosis we needed to get her started on treatment.”
--Dr. Nora Bucher, Evanston, IL