Pelvic Mass Flashcards
how can fibroids present
May be asymptomatic/incidental finding Menorrhagia Pelvic Mass Pain/Tenderness 'Pressure Sx'
what are uterine fibroids
Leiomyomas - benign smooth muscle tumours
Ix of fibroids
1st line = US [diagnostic]
2nd line = MRI [for more precise localisation]
Hb if heavy bleeding
Tx of fibroids
can just leave them be if asymptomatic
if no more children wanted = Tx hysterectomy
what are alternative Tx of fibroids
myomectomy
uterine artery embolisation
hysteroscopic resection
what is protective against ovarian cancer
oral contraceptive pill
what are tumour markers for ovarian cancer
CA 125
Carcino-embryonic antigen [CEA]
what are features of CA 125
Raised in ≈80% ovarian cancers.
BUT Normal level does not exclude cancer
what else can raise CA 125
Endometriosis Peritonitis/infection pregnancy Pancreatitis Ascites from any cause.e.g. liver disease
what tumours especially see a rise in CEA
mucinous tumours
what its the main use of CEA levels
exclude mets from GI primary
Tx of ovarian cyst/mass
Removal or drainage if likely benign
Removal of ovaries and uterus
Chemotherapy
what are cause of acute presentation of pelvic mass
Cyst ‘accident’
- Rupture, Haemhorrhage (into cyst), Torsion
Fibroid degeneration
- Usually ‘red’ degeneration, Compromised blood supply
Seen in pregnancy, peri-menopause.
after an ultrasound has been done, what is the next line Ix if fibroids/uterine mass suspected
MRI
after an ultrasound has been done, what is the next line Ix if suspected ovarian cancer
CT
