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Re: GYN: Ovarian Mass at TVH**the answer From: Braun, R. Daniel (rbraun@iupui.edu) Tue Jun 22 21:54:04 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "Re: GYN: Ovarian Mass at TVH**the answer" Previous message: Garry E. Siegel, M.D.: "Re: GYN: Ovarian Mass at TVH**the answer" Next in thread: Efrain Ramirez: "Re: GYN: Ovarian Mass at TVH**the answer" Reply: Efrain Ramirez: "Re: GYN: Ovarian Mass at TVH**the answer" Send it to the Pathologist. Dan "Sound is like water. If you drill one hole in the wall the sound will leak right through." - JAY BRAUN, a band member by love, a soundproofer by necessity. -----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) Next message: Richard Chudacoff, MD: "Re: GYN: Ovarian Mass at TVH**the answer" Previous message: Garry E. Siegel, M.D.: "Re: GYN: Ovarian Mass at TVH**the answer" Next in thread: Efrain Ramirez: "Re: GYN: Ovarian Mass at TVH**the answer" Reply: Efrain Ramirez: "Re: GYN: Ovarian Mass at TVH**the answer"

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