A 52 y/o postmenopausal gravida 8, para 5, aborta 3 presented with a history of lower abdominal pain and distension for about 10 months. The patient's personal history revealed fatigue, loss of appetite, dyspnea and chronic constipation. LMP 1 year back and she had no post-menopausal bleeding. But her menstruation was 7-8 days of the 21-day menstrual cycle. On physical examination, an abdominopelvic mass with dullness on percussion - a solid mass was palpated. Abdominal tenderness was not present. Gynecologic examination revealed a large, mobile abdominopelvic mass with a normal external genitalia and uterine cervix. Lab tests normal except the Hb level, which was 8 g/dl.

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There is a large ovarian tumour. Get CEA 125 done And an ultrasound guided biopsy to confirm the diagnosis. After proper staging Surgical excision is indicated

Sir. Usg guided biopsy or laprotomy with excision of mass and biopsy after confirmation of physical examination with USG. My concern is if the tumor is EOC then there is high chance of more abdominal seeding.
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Looks like an ovarian fibroma...nevertheless do CA 125, CEA  & CECT... get detailed F/H of breast/ ovarian/ Colorectal cancers... since anaemia is also there evaluate for Upper or lower symptoms also..get a mammogram done...TAH, BSO with frozen and staging laparotomy

Ovarian malignancy most likely.Go for CT abdomen,ROMA index.Relevant investigations for staging if malignant.Followed by leparotomy.& definitive treatment.

A typical case of ovarian tumor. Kindly do CECT abdomen and pelvis and chest thorax. Send serum CA125, LFT, Serum Creatinine. She will need Surgical staging..in the form of Staging laparotomy. If frozen section available can be sent . If not complete the surgical staging with TAH+BSO+Bilateral Pelvic Lymph node dissection+Para Aortic Lymph node dissection+omentectomy+para colic peritoneal biopsies and peritoneal washings for cytology. Don't try laparoscopic.

Case of ovarian malignancy..get ca 125 and other markers along with MRI whole abd and ct scan..plan for laparotomy and surgical staging ...frozen section should be arrange...

Ovarian tumour.USG&laparotomy
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First do a good TtAS and TvS scan with Doppler To find the visceral attachment If susupected to be ovarian go for pet scan and exploratory laparotomy If uterine fibroids laaproscopy Endometriosis laaproscopy

Suspicious ovarian tumour, get CT pelvis, CA 125, involve a Oncosurgeon. Surgical staging and frozen section histopathology will be the best guide to follow on ..

Uterine tumour do CT abdomen guided biopsy HP pet scan if malignant

Malignant ovarian mass

USg... N CT scan to evaluate the Ovarian cyst... N Beta HcG... N Alpha Fetoprotien ratio evaluation... N.. Haematinics also given to a pt to increase a HB%

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