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

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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.

Sure
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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
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Is mass having any ecogenic contents?

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