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Old 06-26-2011
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ObGyn Ovarian Cancer; CT or laparoscopy!

if we find by bimanual examination and U\S a solid mass on ovary in postmenopausal woman what next step

CT image or laparoscopy ??
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Old 06-26-2011
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CT.. why would you want to do a laproscopy?
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Old 06-26-2011
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because in ovarian mass biopsy is most definitive diagnosis
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Old 06-26-2011
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The thing is that if an ovarian mass is felt on abdominal palpation it probably has metastsised.. CT helps to localise the metastasis and helps in staging.. so if its spread too much makes no sense in operatiing the patient...! Thats my logic... I realise that there is a high chance i am wrong
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Old 06-26-2011
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Quote:
Originally Posted by bassatom View Post
The thing is that if an ovarian mass is felt on abdominal palpation it probably has metastsised.. CT helps to localise the metastasis and helps in staging.. so if its spread too much makes no sense in operatiing the patient...! Thats my logic... I realise that there is a high chance i am wrong

I agree with you, especially because laparoscopy is more invasive than a CT scan.
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Old 06-26-2011
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Ovarian cancer is surgically staged. Probably all gynecological cancers r staged surgically except cervical which is staged clinically. So the answer is laproscopy.

Sorry!!!! Should have a CT before surgery. Reference from Kap notes.

Last edited by drahmednawaz; 06-26-2011 at 12:12 PM.
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Old 06-26-2011
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Default Workup ovary mass in postmenopausal women

The first imaging modality should be a pelvic ultrasound. In case of ovarian cancer, the finding will include a complex cyst.

Before a laparotomy, a CT should be obtained to evaluate the mass and, more importantly, assess whether ascitis is present.

If it is, a laparotomy is necessary to perform the surgical staging mentioned before. An oopherectomy is the minimum that will be performed, but the threshold for a total abdominal hysterectomy plus bilateral salpingoopherectomy (TAH BSO) might be lower in postmenopausal women.

If there is no ascitis on the CT, a laparoscopic oopherectomy might be performed.
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