Pelvic Mass Flashcards
Anterior pelvic mass may originate from?
- bladder
Middle pelvic mass may originate?
- uterus
Posterior pelvic mass may originate?
- bowel
Pelvic mass differentials?
- pregnancy
- bladder tumours
- uterine fibroids
- adenomyosis
- leiomyosarcoma
- cervical cancer
- ovarian mass
- tubal mass
- ascites
3 cells of the ovaries?
- surface epithelium
- germ cells
- sex cord stroma
Tumour markers used for ovarian cancer?
- CA-125
- CEA
- Alpha fetoprotein
Explain CA-125 tumour marker?
- elevated in ovarian tumours
- also raised in sarcoidosis, hepatitis, cirrhosis, pericarditis
Explain CEA?
- Present in fetal and embryonic tissue
- not usually in adults
- elevated in ovarian malignancies
CA-125:CEA ratio?
- CA-125:CEA < 25 = Metastatic
- CA-125:CEA > 25 = primary
Alpha fetoprotein used as a tumour marker for what?
- germ cell cancers
- age <40
MRI for ovarian cancer is for what age group?
- premenopausal
- CT (POSTmenopausal)
Explain the weighing of RMI?
- Risk of malignancy index
- Menopusal status
- USS features
- serum CA-125
< 30 = 3 in 100
30-200 = 20 in 100
>200 = 75 in 100
Functional cysts symptoms?
- asymptomatic
- menstrual distrubances
When is intervention performed for functional cysts?
- haemorrhage
- torsion
Endometriotic cyst also called?
- chocolate cysts
- due to presence of old blood
Symptoms of endometriosis?
- dysmenorrhea
- dyspareunia
- treatment = OCP
Dermoid cysts are?
- totipotent
(teeth, sebaceous, hair, thyroid)
- may cause torsion
Treatment of benign ovarian tumours?
- conservative
- medical (gnrh, cop)
- surgical
Explain borderline ovarian tumours?
- grow like benign tumours - but can spread
- better prognosis than ovarian cancer
Treatment of borderline ovarian tumours in young women?
- unilateral cystectomy
- close follow up
Treatment of borderline ovarian tumours in postmenopausal women?
- pelvic clearance
Lifetime risk of ovarian cancer?
- 2%
Red flag symptoms for ovarian cancer
- persistent abdominal distension
- feeling full
- pelvic or abdominal pain
- increased urinary frequency/urgency
Investigations for ovarian cancer?
- CA-125
- USS
- CT
- MRI
Treatment for early stages ovarian cancer?
- surgery followed by adjuvant chemo
Treatment for advanced stages ovarian cancer?
- neoadjuvant chemo then surgery
Secondary ovarian cancer is likely from what?
- metastasis from breast, pancreas or stomach
- CA-125: CEA <25
