Malignant Ascites

Etiology of Malignant Ascites

1. Secondary to abdominal malignancy:

• Especially of the liver, stomach & ovaries.

• The spread is may be direct, lymphatic or haematogenous.

2. Secondary to cancer breast or testis:

Through lymphatic or haematogenous spread.

3. Primary tumours:

As mesothelioma (rare).

Clinical Picture

1. Features of the primary cancer.

2. Abdominal manifestations:

- Rapid distention of the abdomen

- The ascitic fluid is usually massive.

- Intra-abdominal masses may be present.

- There may be no palpable liver or spleen.


- Nodules around the umbilicus.

3. Examination of the ascitic fluid:

- Bloody, but rarely clear or chylous.

- Rapidly recurring after aspiration.

- It may contain malignant cells.

Treatment of Malignant Ascites  is only Palliative .
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