Ovarian carcinomatosis presenting with hyperamylasemia and pleural effusion

A 65-year old patient with hyperamylasemia, amylase rich ascites and pleural effusion presented with massive abdominal distention and ascites. The diagnosis of pancreatic pseudocyst with pancreatic ascites was suggested. The underlying disease was, however, proven to be carcinoma of ovarian origin with diffuse carcinomatosis. The isoamylase was found to be of the genital type, migrating electrophoretic study of amylase rich fluid will enable differentiation of patients with hyperamylasemia into those of pancreatic and extrapancreatic and extrapancreatic origin. A simple and rapid test to differentiate the various pancreatic isoamylases is required.