Saturday 30 November 2013

Ovarian tumors - investigations

Investigations to detect ovarian tumors:
Investigations are used to establish the diagnosis.
To determine the anatomic location, size, and morphology of ovarian tumour as well as possible sites of metastases.
To assess the patient's general condition and ability to undergo a major surgical procedure.
To exclude other primary cancers metastasizing to ovary.

Ultrasound :
Trans vaginal ultrasonography is more accurate for assessing ovarian tumour size and morphology.
This is used to confirm the origin of tumour.
To know the size of the tumor.
To identify the morphology of the tumor.
To differentiate between benign or malignant tumors.
To know the presence of ascites.
To esimate the metastases.


Color flow doppler :
Adds information on neovascularisation and probability of tumour being malignant.

 CT/MRI :
Used to know the extent of the spread of the tumour.
They can recognise the lymphnode involment : Pelvic and paraaortic lymphnodes > 1cm.

FNAC and ascitic fluid cytology: Used to know the type of the tumor and peritoneal spillage of the tumor. 

Chest radiograph and IVP:
Will give the extent of the tumor.

Endometrial sampling:
Is used to know the type and peritoneal spillage of the tumor leading to secondaries in ovary.

 Routine haematologic, biochemical testing, ECG:
Are done to know the general condition of the patient and during preparation for treatment procedures.

Barium meal & enema, upper GI endoscopy, colonoscopy, mammography:
Are done to know the extent of the tumor.

Tumour markers of different ovarian tumors:
These are the substances identified in higher than normal amounts in blood, urine, or body tissues of the patients with specific malignancies. They are produced directly by the tumour or as a response to the presence of cancer.
CA-125 > 35U/ml – Is the tumor marker for epithelial tumours.
CEA > 5ng/ml – Used as tumor marker for mucinous tumours.
AFP – Is the tumor marker for endodermal sinus tumour and embryonal carcinoma.
LDH - Is dysgerminoma's tumor marker.
HCG – Is the tumor marker for choriocarcinoma and embryonal cell carcinoma.
Inhibin –Is the tumor marker of granulosa cell tumour.

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