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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Malignant tumor .

Probable ovarian tumor get CEA125

Ovarian tumour

Malignant ovarian mass

The radiological images could suggest a retroperitoneal tumor because it is almost with solid component with very less cystic component.

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 ..

Ovarian tumor

Consult gynaeoncosurgeon

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

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