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Re: GYN: Ovarian Mass at TVH**the answerFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Mon Jun 21 21:32:50 2004
Sorry to a bit slow in replying. Hindsight is always 20-20, and I wish that i had thought of a couple of the options that you fine colleagues suggested. I especially liked putting it in a bag, as I do think that I could have passed an endopouch and it would have fit. I then could have punctured and drained it and kept the contents under control. I didn't think of simply needling it, as that would spill. I also thought of a laparotomy, as I didn't need a laparoscopy to disconnect it (I did that OK vaginally), and I would need an incision to have removed it intact. So, I easily ligated the blood supply, and while bringing it out through the vagina (no bag, etc.), it did have a pinpoint leak, spilling material that looked like pus. I contained it as best that I could, and the frozen showed a borderline endometriod tumor. The final pathology showed a moderately well differentiated endometriod adenocarcinoma, with minimal stromal invasion. The Gyn Onc suggested a CT of the chest and abdomen, and the likely a staging laparoscopy. The Ca 125 postop was 8. Garry
At Tue, 15 Jun 2004, Garry E. Siegel, M.D. wrote:
>
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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