Is There Any Way To Diagnose Ovarian Cancer By CT Scan And Vaginal Ultrasounds?

Posted on Mon, 20 Jan 2014

Question: Is there any way to diagnose ovarian cancer by CT scan and vaginal ultrasounds only or is the only true way to diagnose with a biopsy of the ovary? I am 48 and have a "20X24X29mm solid left ovarian lesion" on my left ovary. My left ovary is also double the size of my right ovary and my uterus is "enlarged" at 5X6.5X10.4cm. Those measurements are all from a recent vaginal ultrasound. I have heard from 2 doctors there is a strong chance it is a cancer. I see the GYN oncologist on the 6th. My questions are around how will this be diagnosed. The not knowing for certain has been the most difficult part of all of this.

Answered by Dr. Kulsoom Qureshi (4 hours later)

Brief Answer: Yes, biopsy is the surest option for diagnosis. Detailed Answer: Hi XXXXXXX Thanks for consulting us. Ovarian cancer is notorious for its late presentation. Reason is a delayed diagnosis due to ovaries being located inside the body & not available for biopsy without surgery. Biopsy is no doubt the only way for a confirm diagnosis. I have read the details of your medical & family history as well as your reports. Your family history puts you in a high risk group for ovarian cancer. I don't know about your BRCA status ( genetic screening offered to high risk families). However, for those who want to conserve their ovaries biopsy via frozen section before extensive surgery is an option. In this type of biopsy, patient is fully prepared for an extensive surgery & ovaries are biopsied in operation theater. A frozen sample is send to lab for immediate assessment. If cancer cells are present operating team proceeds to complete surgery, otherwise a conservative approach can be adopted depending upon the circumstances. Hope this is a helpful answer for you. please write back if you want to discuss this further. Wish you best of luck. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Kulsoom Qureshi (13 minutes later)

Thank you for your reply. I did do the BRCA and was not considered at high risk. I logically know that the ovaries and uterus need to come out. I also know that for me it will be a major surgery due to the multiple other abdominal surgeries I have had due to the TRAM not holding and needing to fix multiple hernias. Could you help be better understand what the results of my vaginal ultrasound mean. 1. How uncommon is it for a left overy to be douple the size of the right one? 2. How concerned should I be about this left overarian lesion that is the same size as my right ovary 3. What exactly does: Relatively echolgenic, nonshadowing 20 x 24 x 29 mm solid left ovarian lesion mean? 4. What does it mean when they say: Mild internal blood flow on color Doppler imaging Ovarian blood flow evalation Doppler spectral analysis demontrates 0.6 left and 0.7 right RI? Thank you for your guidance. Your feedback is helping me to prepare for my first visit with the GYN Oncologist next week

Answered by Dr. Kulsoom Qureshi (1 hour later)

Brief Answer: Simple inerpretation: Detailed Answer: Hi XXXXXXX Thanks for your reply. This is good that you understand the nature & complexity of surgery you need. Enlarged ovaries are very common in women during their reproductive years due to PCOS. However, having a solid mass is abnormal regardless of size & warrant further testing. Generally about 6-7% women have ovarian masses & only 20% are malignant. A solid mass which is echogenic & has blood supply on doppler means a viable lesion, that may turn out to be malignant, however, diagnosis is possible only after biopsy. Tumor markers like Ca-125 can further tell us the risk of malignancy. This is the simplest interpretation I can offer. Your Oncologist visit will give you more insight into the problem. Wish you good health & please contact back if you need further help. Best regards.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar