Ovarian mass

64 yr old nulligravida with ovarian mass Chief Complaints Abdominal pain since 6 months History Abdominal pain since 6 months. Nobladder bowel disturbances Vitals Stable Physical Examination Mass arising from pelvis around 26 weeks size of gravid uterus. Investigations CA 125-- 304. CECT Abdopelvis showing ovarian mass 17*14*13 cm. Management Kindly opine on further management



Likely malignant, what is the RMI score ?debulking surgery, Exploratory laprotomy f/b hysterctomy plus BSO, pelvic lymph node,peritoneum sampling , and ascitic fluid cytology with surgical staging to be done , further management according to hpr.

Respected Madem, RMI Is helpful if pt.is on Chemotherapy following surgery to assess RESPONSE & to predict RECURRENCE by considering Age , CA 125 , Ultrasound.

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Ca125 is a markar not cent percent diagnostic of cancer so fnac to confirm diagnosis Opinion of obstetrician Continue pregnancy with follow up of usg any pressure effect

Age 64 , there is no pregnancy

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Ovarian tumor is to be removed and histopathology to be done. Although nullipara , aged 64 with ovarian itself suggestive of malignancy

I agree sir

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@Dr. Viraj R. Naik ,please do share intraop findings and hpr of this case.


First thing is this case presented him self is GYNAECOLOGIST, attached to medical college as teaching faculty. Second thing is at this age CA 125 is more significant ( cut off value is 35 ) Third thing is fnac sensitivity is very less Below 25 % . Best is post her for staging Laparotomy HPR & Chemotherapy.

I agree

Is mass having any ecogenic contents?

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