Re: CA 125 of 103
From: S Osterling M.D. (sdoesterling-obgyndotnet@yahoo.com)
Sat Feb 11 15:57:09 2006
Joanne,
I am a non-gyn/onc. We just took a 50 y/o lady with a 4 cm solid tumor
to the OR - ca-125 of 42. We expected an ovarian fibroma. We got
epithelial ovarian cancer. I'm glad I booked my gyn/onc to come to OR.
On Feb 10, 2006, at 10:27 PM, Joanne Bulley, MD wrote:
> Excuse me John, if this case (or its management) seems offensive to
> you!
>
> She had DUB for which the first ultrasound was ordered.
>
> Additional history is that both her mother and sister have breast
> cancer
> and her maternal grandmother died of ovarian cancer.
>
> I have done at least one laparotomy in my career where there was an US
> with findings of ovarian abnormalities that were non-diagnostic, CA 125
> done day of surgery normal ... stage 3C Ovarian CA, patient dies of
> disease.
>
> I am currently following someone who has been treated for Stage IIIc
> Fallopian tube CA whose CA 125 was 125 or 150.
>
> This current patient has had no cesareans.
>
> Remember - the original US was done for DUB. The follow up US was done
> because the radiologists thought the left ovary had two cysts and one
> was septated.
>
> I reviewed all the possibilities and probabilities - and she is
> scheduled for a laparoscopy by me with curgery as indicated by
> findings.
>
> Joanne
>
> At Fri, 10 Feb 2006, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
> wrote:
>>
>> 1.) Gyn oncologists up here are to busy doing real Gyn onc surgery to
>> take a ca 125 of 103 and a small cyst in 40 y.o. seriously,; I do ca
>> 125 also ,as I hand them the lab req I tell them if it comes back 1000
>> its probably not good, if it comes back 100 its probably not cancer
>> but
>> you will end up with an operation.
>>
>> 2.) sure do the laproscopy, most of my ca 125 of 100 cases have had at
>> least 2 preious c-sections and end up with a laparotomy(which is not
>> the
>> end of the world.)
>>
>> 3.) MRI will tell you she has a cyst, you already know this, it was a
>> mistake to do the U/S don't compound it with another mistake.
>>
>> 4.) Tell her that if you find severe endometriois that you would
>> reccomend a hyst BSO.Tell her if its hydrosalpinx left over from her
>> tubal you will remove it.
>>
>> --
>> Take care, John
>>
>
> --
> Joanne Bulley, MD
> Keene, NH, USA
>
S. Osterling M.D.
California
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