Pelvic mass Flashcards
What staging criteria is used for gynaecological tumours?
FIGO staging
FIGO staging is based on clinical staging meaning careful clinical examination is carried out before definitive therapy. True/false?
True
With the exception of the ovary which includes surgical exploration
Anatomical structures of the pelvis?
Anterior compartment - bladder
Middle compartment - uterus
Posterior compartment - bowel
Lateral compartment - adnexae (region adjoining the uterus that contains the ovary and fallopian tube)
Bleeding = what gynaecological cancer?
Uterine (most common is endometrial)
Pain = what gynaecological cancer?
Ovarian
Pressure symptoms = what gynaecological cancers?
Uterine or ovarian
Long term symptoms lasting months/years usually indicates malignancy. True/false?
False
Short term symptoms lasting weeks are usually associated with malignancy.
Long term symptoms lasting months/years usually associated with being benign.
What is a bimanual pelvic examination?
bimanual pelvic examination (BPE) is used to check a woman’s internal pelvic organs.
The health care provider inserts two fingers into the vagina and then places pressure with the other hand to the lower part of the belly.
Uterine cancer features?
Symptom: bleeding
Bimanual examination: midline, lobulated mass, moves with cervical motion and non-tender
Ovarian cancer features?
Symptom: pain
Bimanual examination: lateral, occupying fornices, no movement with cervical motion and can be tender
Features of a benign mass?
Appearance over months/years
Smooth mass, mobile (moveable)
Features of a malignant mass?
Acute appearance (over few weeks)
Cachexia (wasting of body), ascites, craggy mass (uneven mass) and not mobile (not moveable)
Acute masses present with what symptoms and features?
Doubling pain with nausea
Bimanual examination: tender abdomen, rebound, guarding (tensing of abdominal muscles to guard inflamed organs) and exquisite cervical excitation
What is CA-125?
A tumour marker that can be used to detect ovarian cancer if shown in high levels in the blood.
Can CA-125 be high without cancer?
Yes
In pre-menopausal women, what benign conditions can cause raised CA-125?
diverticulitis, endometriosis, liver cirrhosis, pregnancy, and uterine fibroids
Other tumour markers that can be used in women < 40 years old?
Alpha foeto-protein - raised in embryonal carcinoma
HCG - raised in choriocarcinoma
LDH - raised in dysgerminoma