Left ovary mass

Chief complaint A 37 y/o G2P2 female presents with abdomen discomfort and ascites. History She has h/o cystic mass of the left ovary measuring 20 cm one year back. Laparotomy was performed with removal of the ovary & had chemotherapy later. Initially the treatment was effective but then again started having abdomen discomfort and ascites. She has 2 children both healthy. Treatment What should be done about abdominal pain and ascites now?




Tnx Dr Vipin Bihari Jain sir

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RECURRENCE OF OVARIAN MALIGNANCY.For ovarian mass or cyst before surgery thorough investigation required to rule out suspicion of malignancy. Prior histopathology report needed for further accuratetreatment. At present do thorough investigation to rule out secondary in abdomen as well as other areas like Lung's and adrenals. Furthere treatment depend on site of secoundary. Do CA 125, CEA,USG, whole body PETscan,CT SCAN ABDO PELVIS,x-ray chest cimple blood investigation. Aspiration of Ascitic fluid cytology required.treatment plan may be chemotherapy or chemoradition , or adjunct chemotherapy depend on tumor extension.

Recurrence Ca. PET CT scan whole body. Ca 125. Needs further investigation and evaluation to conclude and treatment plan.

Thanks Dr Vipin Bihari Jain

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Get ultrasound done ,secondary in liver may be possible. Consult Oncologist

Thanks Dr. Kute Ankush, Dr. Nazia Tabassum, Dr. Dinesh Gupta

Ascitis is there suggestive of Secondaries.Adv CA 125 MRI abdomen Refer her to Oncologist.

Metastatic drainage involved. Consult Oncologist.

Suggestive of recurrence Get a whole body PET CT scan Serum Ca 125 CBC LFT Kindly refer the pt to oncologist surgical for further evaluation and management

improve the immunity and give

Needs detail HPR reports to opine

Case of recurrence or secondaries.. Do ca 125 .. PET SCAN for mets.. Send ascitic fluid for cytology.. If needed diagnostic lap if suspecious of peritoneal /omental or other mets.. Send biopsy for diagnosis .. After hpe report She may require chemotherapy..

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