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Re: Tumor question From: Dr. Montgomery (apgar10@thebirthcentermt.com) Wed Mar 7 09:23:23 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. Montgomery: "Re: Dr. Siegel re: pre eclamptic patient" Previous message: art fougner, md: "Re: Dr. Siegel re: pre eclamptic patient" In reply to: art fougner, md: "Re: Tumor question" Art, The lesion does not appear like a hemorrhagic cyst, but rather complex with solid and cystic components. With all the scans I do, although not a medical term, it appears "angry". Lynn Lynn D. Montgomery, M.D. Obstetrics & Gynecology, Maternal-Fetal Medicine The Birth Center/Rocky Mountain Women's Health 1211 S. Reserve St. Missoula, Montana, 59801 406-549-0978 fax 406-549-0987 e-mail: apgar10@qwest.net -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art fougner, md Sent: Wednesday, March 07, 2007 9:05 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Tumor question Lynn Is this mass present after a follow-up ultrasound? If this is the first sonar for this patient, why not a follow-up sonar after one complete cycle, in the early follicular phase, to note interval change. From what you present, this still could simply be a hemorrhagic cyst. Art At Tue, 6 Mar 2007, Dr. Montgomery wrote: > >Could use y'all's opinion on this one. > >38 y.o. presents for exam - new to the area. History is that of having a >"mixed malignant germ cell tumor" with "foci of embryonal carcinoma" in '89, >at the age of 19. She had the involved ovary, as well as the tube removed >and no signs of mets. Had three rounds of VP 16, Bleomycin and cisplatinum. >Following that, she had three ectopics, ultimately resulting in the removal >of the remaining tube. In 2004, had successful IVF resulting in term twins, >and also has frozen embryos from that and strongly desires more babies. > >At the time of presentation, she states that she is having symptoms similar >to those she had in '89. Ultrasound shows a complex appearing mass on the >remaining ovary measuring 3.7 x 4.7 cm - consistent with a similar neoplasm. >Tumor markers of HCG, AFP and CA-125 pending. > >Certainly needs to be explored to determine the nature of the mass, given >the history. > >Questions that come to mind: > >1. Previous horizontal incision - now do a vertical? > >2. If positive for tumor and it can be "shelled out", would anybody be >conservative to retain the ovary - given the pregnancy considerations? > >3. If positive for similar tumor and no signs of mets, >salpingooopherectomy and leave the uterus for future pregnancy - "staging" >won't be back until post-op? > >4. Risk of recurrence with pregnancy? > >Lynn > >Lynn D. Montgomery, M.D. > >Obstetrics & Gynecology, Maternal-Fetal Medicine > >The Birth Center/Rocky Mountain Women's Health > >1211 S. Reserve St. > >Missoula, Montana, 59801 > >406-549-0978 > >fax 406-549-0987 > >e-mail: apgar10@qwest.net -- art fougner, md "May The Wings of Liberty Never Lose a Feather." - Jack Burton Next message: Dr. Montgomery: "Re: Dr. Siegel re: pre eclamptic patient" Previous message: art fougner, md: "Re: Dr. Siegel re: pre eclamptic patient" In reply to: art fougner, md: "Re: Tumor question"

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