Pelvic Mass

Question 1

Answer 1

Question 2

Answer 2

Question 3

38-year-old woman, with long-term menorrhagia, midline mass that moves with cervical motion, non-tender on examination

Answer 3

Uterine fibroids

Question 4

38-year-old, pain on right side, dyspareunia, dysmenorrhoea, 6 cm mass in the right fornix, does not move with cervical motion

Answer 4

Adnexal mass

Question 5

38-year-old, pain on the right side, dyspareunia, dysmenorrhoea.

For the past 2 days pain has increased, intermittent + nausea
On examination, tender in the right iliac fossa, rebound tenderness present, she has a 6 cm mass in the right fornix, does not move with cervical motion, cervical excitation present

Answer 5

Adnexal mass, acute event

Question 6

HCG is raised in which cancer?

Answer 6

Choriocarcinoma

Question 7

Alpha foeto-protein is raised in what cancer?

Answer 7

Embryonal carcinoma

Question 8

LDH is raised in which cancer?

Answer 8

Dysgerminoma

Question 9

Features of malignant gynae cancers

Answer 9

Irregular solid tumour, presence of ascitis, 4 or more papillary projections and increased vascularity

Question 10

Features of benign gynae cancers

Answer 10

If the cyst if unilocular MEANING a single compartment, has a solid compoenent measurign less thatn 7 mm, no increase in vascualirty
Even if mulitlocualted, the largest diameter is less than 10mm

Question 11

Investigation for uterine fibroids

Answer 11

USS +/- MRI

Question 12

Investigations for adnexal mass

Answer 12

Ca125, LDH, AFP, HCG, USS +/- MRI

Question 13

Investigations for adnexal mass – Acute event

Answer 13

USS/ Theatre

Question 14

Dermoid cyst unusual feature

Answer 14

Totipotent cells - can grow teeth, hair

Question 15

Treatment of fibroids

Answer 15

CONSERVATIVE
MEDICAL MANAGEMENT – HORMONAL Mx for bleeding, GnRH agonists
Surgical management – myomectomy, hysterectomy
Interventional radiology – UTERINE ARTERY EMBOLISATION