Re: Tumor question
From: art fougner, md (evsono@pipeline.com)
Wed Mar 7 09:58:46 2007
I'd take your word for it, Lynn ... I've seen many masses resolve in a
short period of observation - ( mood swings in masses?) I'd have ONC see
this young lady in consult. Are your labs back yet?
Art
At Wed, 7 Mar 2007, Dr. Montgomery wrote:
>
>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
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
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