Cystic lesion with ascitis

Female age 30 yr Chief Complaints Pain abdomen Abdominal distension aftr taking food Ghbrahat in evening History H/o cough 8 mnth back , no c/o cough Menstrual cycle normal Vitals Vital normal Investigations Cbc ,ca 125 ,rbs Ct abdomen USG Report attached

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Pulmonary tuberculosis and Tuberculosis of abdomen Ca 125 is raised in tuberculosis of abdomen and it normalises after complete treatment of abdominal Tuberculosis There is extensive literature on the subject of CA 125 and Tuberculosis Finding favouring tuberculosis 1) lymph node mass in pelvis 2) Lymph node mass in mesentery 3) Right pleural effusion 4) Pleural thickening 5) Terminal ileal thickening 6) Raised CA 125 Finding going against Carcinoma of ovaries 1) Young age 2) Both ovaries are bulky but there is specifically no ovarian mass, in absence of ovarian mass diagnosis of CA ovaries is unlikely 3) CA ovaries usually has CA 125 level raised in thousands, CA 125 is only 121 which goes against diagnosis of CA ovaries Adv Pleural fluid tapping and analysis for ADA TB culture Gene Xpert Routine and microscopy Protein Provisional diagnosis Extensive Tuberculosis affection lungs and abdomen

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Complex Cystic ovarian mass rt side With Ascitis Cancer antigen high Pleural effusion With thickening Lymphadenopathy Suggestive of ovarian cancer with secondaries Guarded prognosis Consult an Oncologist

CA 125 is high Ct scan suggestive of ovarian mass with para mesenteric lymphadenopathy Malignancy ovarian tumor Adv laproscopic biopsy for confirmation D/d GUT tuber

Thanx dr Pushkar ji Bhomia
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Right ovarian complex cystic mass with moderate Ascitis with significantly raised CA - 125 with pulmonary involvement- most likely a case of Ovarian carcinoma with metastasis. After a diagnosis laparoscopic and biopsy- a PET scan may be required before starting the treatment

Cystic sewling overly with ASCITIS Cancer antigen vary high Involved lymphnod e Pleural effusion All these findings suggest CS ovary with metastasis

? RT .. OVARIAN COMPLEX CYSTIC MASS...WITH.. ASCITES.. ANEMIA.. NEED'S.. CA 125 .. HIGH .. GYNECOLOGICAL EXAMINATION..

D/D include TB and ovarian Ca. Tap ascites send for ADA, cytology, Gene Xpert and TB culture. Decide based on these tests. Ca ovary can be seen in young (specially with BRCA mutation, Family h/o cancer???) so do not just go after the TB diagnosis.

For, COPD Rx Punarnavashtak qwath BD Kanchnar guggul 2bd Galo ghan tab 1bd SH tab 1bd

think,,vriddhi vadhika vati and kachnar gugglu could do some thing...

?CA ovary ? Abdominal Koch's.. Confirmed diagnosis biopsy R/m, ADA level, cytology study, ESR

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