{"ok":true,"case":{"slug":"catalina","displayTitle":"Case Study: Catalina","shortTitle":"Catalina","topic":"Ovarian cancer","subtitle":"A longitudinal evidence-based case study","tagline":"Understanding the clinical course, treatment context and evolving evidence.","language":"en","status":"published","reviewedAt":"2026-10-30","publicSummary":"An educational research case about ovarian cancer, built from reviewed records as they are curated. It keeps apart what happened, what is documented, what was available at the time, what is known today and what remains experimental or uncertain. One person's history is not a treatment plan for another person.","documentedDiagnosis":"Ovarian cancer is the approved topic of this case. Histological subtype, grade, stage, biomarkers, dates and treatment responses are not documented here until reviewed records are published; they are never inferred from the illustration, from general articles, from receipts or from a section title.","scope":"Public educational reference built from a separately curated and minimized projection of private records, published only through an explicit approval. The private originals, working notes and identifying details are not part of the public case.","limitations":["The detailed medical chronology has not been approved for publication; the timeline and the treatment sections show their structure with honest empty states.","A retrospective family recollection is labeled as such and is not a medical record.","A prescription, a medication note, a scheduled appointment and a confirmed administration are different events; a receipt is not an administration record.","Isolated laboratory values are not turned into response charts without a reviewed clinical interpretation; a missing value is not zero.","Knowledge available today is not applied backwards as proof that an earlier decision was wrong."],"howToRead":["Overview says what the case is and what it is not.","Clinical timeline lists reviewed events; each one shows its event date, document date and entry date separately, with its date precision, evidence type and uncertainty.","Treatment landscape keeps three views apart: what was available at a historical date, what is reviewed today, and what is investigational.","Evidence lists the references the case actually uses, with provenance, review dates, corrections and unresolved questions.","Questions for your care team offers neutral prompts for a consultation; it does not recommend anything."],"illustration":{"src":"/assets/images/labs/biolab/case-catalina-ovary-626.webp","srcset":"/assets/images/labs/biolab/case-catalina-ovary-480.webp 480w, /assets/images/labs/biolab/case-catalina-ovary-626.webp 626w","sizes":"(max-width: 1023px) calc(100vw - 40px), 560px","width":626,"height":238,"alt":"Educational conceptual illustration of an ovary with a magnified inset of cells. It is not a clinical image of Catalina and is not evidence of tumor appearance, subtype, extent or stage."}},"revision":{"number":2,"approvedAt":"2026-10-30T17:55:20.544Z","note":"Clinical events transcribed from the IMSS medical summary GIN/004 (18 May 2022); editorial review only; publication approved by the case owner on 2026-10-30."},"events":[{"id":"evt-3f435b3a-e","eventType":"test","title":"Diagnosis of non-Hodgkin lymphoma","summary":"Non-Hodgkin lymphoma diagnosed in 2000, according to the 2022 medical summary, which gives the year only.","findings":"The summary states a diagnosis of non-Hodgkin lymphoma in 2000, treated with radiotherapy the same year and under surveillance from 2001.","uncertainty":"Month, lymphoma subtype, stage and the diagnostic method are not stated in the summary.","eventDate":{"precision":"interval","start":"2000-01-01","end":"2000-12-31","label":"in 2000 (year only, as the medical summary states it)"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:29.344Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-172448f6-1","eventType":"administration","title":"Radiotherapy for the lymphoma, 30 fractions, completed in 2000","summary":"Radiotherapy for the lymphoma, 30 fractions, completed in 2000 according to the medical summary.","findings":"Thirty fractions, completed in the same year as the diagnosis (2000), as recorded in the summary.","uncertainty":"Start date, treated site, dose per fraction and total dose are not stated.","eventDate":{"precision":"interval","start":"2000-01-01","end":"2000-12-31","label":"completed in 2000 (year only, as the summary states it)"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:30.343Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-fa301242-3","eventType":"outcome","title":"Lymphoma surveillance from 2001","summary":"Under surveillance for the lymphoma from 2001, according to the medical summary.","findings":"The summary records surveillance from 2001 and mentions no relapse of the lymphoma.","uncertainty":"The surveillance schedule and its findings are not described in the summary.","eventDate":{"precision":"approximate","date":"2001-01-01","label":"from 2001 (year only, as the summary states it)"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:31.197Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-d60d68f5-1","eventType":"test","title":"Diagnosis of ovarian cancer, stage IV (pleural effusion), poorly differentiated adenocarcinoma","summary":"Ovarian cancer, stage IV because of a pleural effusion, with a diagnosis of poorly differentiated adenocarcinoma, as stated in the 2022 medical summary.","findings":"Stage IV assigned on the basis of a pleural effusion; histology reported as poorly differentiated adenocarcinoma. The summary presents the laparoscopy of 17 October 2020 as a consequence of this diagnosis.","uncertainty":"The date of diagnosis, the histological subtype beyond 'poorly differentiated adenocarcinoma', biomarkers and how the effusion was confirmed are not stated.","eventDate":{"precision":"approximate","date":"2020-10-17","label":"shortly before the laparoscopy of 17 October 2020 (date not stated)"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:32.018Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-99f7054e-a","eventType":"procedure","title":"Laparoscopy at another institution","summary":"Laparoscopy performed on 17 October 2020 at an institution other than the IMSS Oncology Hospital, according to the medical summary.","findings":"«fuera del hospital»: performed outside the IMSS Oncology Hospital, on 17 October 2020.","uncertainty":"The institution, the findings of the laparoscopy and whether tissue was taken are not stated.","eventDate":{"precision":"exact","date":"2020-10-17"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:32.797Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-9e796758-1","eventType":"administration","title":"Adjuvant chemotherapy, four cycles, completed","summary":"Adjuvant chemotherapy, four cycles, administered at the IMSS Oncology Hospital and completed on 10 March 2021, according to the medical summary.","findings":"Four cycles administered at the hospital that issued the summary; the last one ended on 10 March 2021.","uncertainty":"Drugs, doses, schedule and the start date are not stated in the summary; no regimen is named here.","eventDate":{"precision":"exact","date":"2021-03-10","label":"date the fourth and last cycle ended"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:33.542Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-80d9ee42-5","eventType":"procedure","title":"Interval cytoreductive surgery, reported as optimal","summary":"Interval cytoreductive surgery on 17 May 2021, reported as optimal: hysterectomy, bilateral salpingo-oophorectomy, omentectomy and bilateral pelvic lymphadenectomy, without complications.","findings":"Optimal cytoreduction consisting of hysterectomy, bilateral salpingo-oophorectomy, omentectomy and bilateral pelvic lymphadenectomy; no complications reported.","uncertainty":"Residual disease measurement and the pathology of the specimens are not stated.","eventDate":{"precision":"exact","date":"2021-05-17"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:34.301Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-36c2d907-f","eventType":"outcome","title":"Hospital discharge after the cytoreduction","summary":"Discharged on 19 May 2021 after the cytoreduction, without complications, according to the medical summary.","findings":"Discharged two days after the surgery; the summary reports no complications.","uncertainty":"Nothing further about the postoperative course is stated.","eventDate":{"precision":"exact","date":"2021-05-19"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:35.087Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-9d42282d-4","eventType":"test","title":"Tumor marker reported negative at the gynecologic-oncology evaluation","summary":"At the gynecologic-oncology evaluation of 26 January 2022 the tumor marker was reported negative, according to the medical summary.","findings":"«su marcador tumoral fue negativo»; reported at the evaluation of 26 January 2022.","uncertainty":"The marker is not named and no value or reference range is given.","eventDate":{"precision":"exact","date":"2022-01-26"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:35.737Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-732aa5d1-b","eventType":"outcome","title":"Evaluation of 26 January 2022: stable, no evidence of recurrence, ECOG 0","summary":"At the last gynecologic-oncology evaluation recorded in the summary (26 January 2022) she reported no symptoms, was considered stable with no evidence of recurrence, and had an ECOG performance status of 0.","findings":"Asymptomatic by her own account; considered stable, without data of recurrence. Physical examination: conscious, ECOG 0, abdomen soft and depressible, non-tender, no tumor activity.","uncertainty":"Imaging at that visit is not described; the summary records the examination and the tumor marker only.","eventDate":{"precision":"exact","date":"2022-01-26"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:36.633Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-c084da24-1","eventType":"outcome","title":"No evidence of disease, stable, as of the medical summary","summary":"As of the medical summary of 18 May 2022, the patient was reported without evidence of disease and stable.","findings":"«Paciente actualmente sin datos de enfermedad, estable.» This is the status stated on the date of the summary.","uncertainty":"The summary does not say which findings support the statement beyond the 26 January 2022 evaluation.","eventDate":{"precision":"exact","date":"2022-05-18","label":"date of the medical summary"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:38.117Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}},{"id":"evt-46fc6dd7-4","eventType":"appointment","title":"Follow-up appointment with a control CT scan","summary":"A follow-up visit was scheduled about four months after the 26 January 2022 evaluation, with a control CT scan, according to the medical summary.","findings":"«se citó en 4 meses con una tomografía de control». Whether the visit took place is not stated in this document.","uncertainty":"Exact date and whether the CT was performed are not stated.","eventDate":{"precision":"unknown","label":"about four months after 26 January 2022, with a control CT (exact date not stated)"},"documentDate":"2022-05-18","recordedAt":"2026-10-29T06:26:37.410Z","certainty":"documented","recollection":false,"evidenceType":"medical-record","sourceReference":"medical-record dated 2022-05-18","relatedEvidenceIds":[],"review":{"role":"editorial","scope":"Editorial review only: transcription from the IMSS medical summary GIN/004 (18 May 2022) checked against the document; publication approved by the case owner. No clinical-specialist review.","at":"2026-10-30"}}],"evidence":[],"notes":[]}