Right vaginal mass

Chief Complaint A 25 y/o female came with the complaint of right lower abdomen pain, & frequent micturition with the incomplete evacuation of the bladder and difficult passage of stools for 2 months. Examination It shows a large hard vaginal mass Investigations Ultrasound shows a large complex right parauterine mass. CECT of the abdomen showed a 12 × 10 × 12 cm mass in the pelvis,it was suggestive of a malignant ovarian mass. Diagnosis Can you comment on the diagnosis? Treatment Please advise further step

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Do laprotomy , complete inspection of cavity, remove the mass and send for FROZEN SECTION, if benign only cystectomy sufficient if borderline or malignant then proceed for complete surgical staging that includes,total hysterectomy+bilateral salpingectomy+ omental biopsy+ peritoneal stripping . further management and chemotherapy depends on final histopathology and immunohistochemistry.

ADNEXA model of IOTA will help to differentiate between malignant and benign before surgery.
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She is very young age At this age ovarian tumors comprise of germ cell tumors such as mature/ immature teratoma, yolk sac tumor, embryonal cell carcinoma Epithelial tumors such as adenocarcinoma are relatively uncommon Tumor markers such as Alfa feto protein, beta HCG and CA 125 will give clue to the diagnosis

CA125 to confirm malignancy MRI for Gynecological evaluation Removal and histopathological examination of mass. Further treatment on report

Thanks Dr. Kute Ankush Dr. Mehul Nayak
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Ca125 must be done to rule out malignancy as well as MRI must be done to know the extent n involvement of other tissues

? UTERINE PATHOLOGY.. ? OVARIAN PATHOLOGY.. NEED'S.. CA 125 .. MRI STUDY.. GYNECOLOGICAL EVALUATION.. EXPERTS OPINION..

Tnx Dr Vipin Bihari Jain sir
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Diffreszntial diag. First ca 125 to rule out malignancy. could be benign terratoma. Remove and send for biopsy

Get MRI whole abdomen Ca125 Surgery depends on extent of metastasis

My D/D 's are 1. Haemorragic cyst like corpus luteum cyst 2. Endometrioma 3. Germ cells tumors 4. Serious cystadenoma ( with papillary projections 5. T O mas ( if married) . TREATMENT AS PER INVESTIGATIONS TO BE NEEDED.

Do MRI.. CA125 If CA125 -ve then start HRT therapy Kanchnaar guggulu Kanchnaar kashaya Guggulutiktam tab Varanadi kashaya

I agree with Dr Jayesh. Would like to add MRI to asess extent and operability Tru cut needle biopsy from vaginal mass

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