
What Does This CT Scan Report Indicate?

This is XXXX.
My friend's wife is detected by doctor for a Tumour in Ovary (Right Side). Doctor asked for couple of tests.
Out of which her CT - Scan (Abdomen) report depicts the following:
Left Ovary : Normal in size, shape and attenuation. No focal lesion seen.One large abdomino-pelvic cystic SOL(14.2cm / 9.2cm / 15.6 cm) with septation noted. no abnormal calcification seen. Fat Margin is maintained. No. significant paraaortic lymphnodes noted.
CA 125 report depicts the result - 46.9 under unit (u/ml)
USG Report says - Large Cystic Ovarian Tumour - Unlikely to be benign
Please suggest whether it is tending to be cancerous? Or other malignancy?
We are attaching the scan copies of all the reports for your kind suggestions.
Regards,
XXXX XXXXXXX
possibly malignant ovarian tumour.
Detailed Answer:
Hello,
Thanks for the query to hcm,
The fact that there is a large abdominopelvic mass of 15cm size with internal septations on CT SCAN and solid nodules in USG but no para-aortic lymph node involvement and maintained fat margins indicate it to be a possible dermoid or malignant ovarian tumour as CA125 is also high. It is important to get other ovarian specific tumour markers also done like CA 19.9, CEA, AFP &Beta HCG.
Anyhow exploratory laparotomy shall be required and a pre operative frozen section shall be required to confirm the malignancy status on table before proceeding with further extensive surgery of total abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic and para-aortic lymph node dissection if the section turns out to be malignant.
Regards


Is there any chance to be cured ? Or post complication will arise.
Normally what happens in common cases?
Please advise.
Regards,
XXXX XXXXXXX
staging is always surgical in ovarian tumours
Detailed Answer:
Hello,
In cases of ovarian cancer, staging is decided only surgically. So a frozen section is a must during the operation and then further decision to proceed with hysterectomy would have to be taken. Post the operation , the specimens shall be sent for histopathology and then the staging shall be decided based on histopathology and then if there is a need for chemoradiation , then that can be decided upon.
Al cases of established ovarian tumour have to undergo TAH+BSO + pelvic lymph node dissection to prevent recurrence, which is followed by chemoradiation and then 6 monthly follow ups for next 2 years and then yearly.
So thats the protocol. The earlier it is detected and operated upon , the prognosis is better.
Regards

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