Re: GYN: Ovarian Mass at TVH**the answer
From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Wed Jun 23 08:54:46 2004
Laparoscopic oophorectomy with frozen section
--
Richard Chudacoff, MD
Beer is living proof that God loves us and wants us to be happy.
Benjamin Franklin
Heaven grant that the burden you carry may have as easy an exit as it had an
entrance.
[Prayer To A Pregnant Woman]
-Desiderius Erasmus
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain
Ramirez
Sent: Tuesday, June 22, 2004 7:07 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: GYN: Ovarian Mass at TVH**the answer
Along those lines - patient not mine so forgive if no more details are
given but essentially -- 53 y/o post menopausal - no ERT - incidental
finding on an US - simple cyst without excrescences --6 cms - previous
U/S no cyst -- doppler flow WNL - Ca 125 = 27 - next step?
>At Tue, 22 Jun 2004, art fougner, md wrote:
>
>Garry
>
>you MADE the diagnosis and the patient will receive appropriate therapy
>...
>
>art
>
>At Mon, 21 Jun 2004, Garry E. Siegel, M.D. wrote:
>>
>>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:
>>>
>>>62 YO P3003 with symptomatic procidentia, otherwise normal exam.
>>>
>>>At planned TVH/BSO/repairs and sacrospinous ligament fixation, after the
>>>uterus was out, the left ovary was, lo and behold, 6-8 cm., white,
>>>smooth, no excresances, etc. The other ovary/tube/pelvic structures
>>>were all pristine, there was no ascites when opening the peritoneal
>>>cavity, and the enlarged ovary was not evident to me during examination
>>>under anesthesia.
>>>
>>>At this point, both infundibulopelvic ligaments are accessible, meaning
>>>that transvaginal removal is possible. However, I'm not so sure that I
>>>can get the ovary out without rupture.
>>>
>>>What would you do? I've already done it and know the results!
>>>
>>>Garry
>>>
>>>--
>>>Garry E. Siegel, M.D.
>>>Private Practice
>>>Roswell, GA
>>>
>>--
>>Garry E. Siegel, M.D.
>>Private Practice
>>Roswell, GA
>>
>--
>art fougner, md
>ich bin ein New Yorker
>
--
"The opposite of a correct statement is a false statement.
But the opposite of a profound truth may well be another profound truth."
Niels Bohr (1885 - 1962)
