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Re: Two interesting cases in one day, your opinions pleaseFrom: DoctorJoe@aol.comSat Jul 22 07:53:26 2000
In a message dated 7/21/00 10:53:40 PM, drdanf@earthlink.net writes: << A 17 y/o G2 P1 at 26 wks with off/on right lower quadrant pelvic pain. Crampy in nature, felt like gas pains to her. A certain dull ache always was there, but got worse at times. Various GI meds didn't seem to help, so I had an US done today looking for some uterine anomaly or perhaps a GU stone. Well, the tech called me downstairs for this one. There is a 12X16cm homogenous mass arising from the right adnexa. No ascites, the liver,gallbladder, fetus, placenta, left adnexa are fine. This looks a lot like a serous cystadenoma, and likely benign given her age, and the cyst characteristics. What would you do? Surgery now or later at term? Would you need to do a C/S if the cyst is a big water balloon? >> Get a second opinion about how benign it "looks"... if you all agree, then wait. 26 weeks is a little late to operate, since she'll deliver in a reasonably short period of time. OTOH, if anyone thinks it might NOT be benign, then take it out ASAP... but leave lots of more invasive gyn-onc stuff (chemo?) until after delivery. You'd have the path report to decide how bad it was and you could figure out if she needed to be delivered early or not. Joe P.
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