Re: Ovarian Torsion

From: Malcolm Griffiths (Malcolm@mgriff22.demon.co.uk)
Sat Jun 29 17:18:37 1996


In message <v03006f04adf524061ff7@[199.1.103.181]>, "Geffrey H Klein, MD" <gklein@bcm.tmc.edu> writes >This patient is a 64 year old multiparous female who presented with a
>complaint of increasing abdominal girth and postmenopausal spotting.
>Ultrasound of the abdomen revealed a complex cystic and solid abdominal
>mass of 21 centimeters in largest dimension. She had normal tumor markers
>including a normal CA125. However, she was noted on exam to have hirsutism.
>Total testosterone was 206 and DHEA-S was normal.
>
>The patient was taken for exploartory laparotomy. Upon opening the abdomen,
>it was noted that the ovarian vessles were torsed. The mass was
>exteriorized without untwisting the torsion.
>
>Once removed, the mass was sent for frozen section. This was a mucinous
>cystadenocarcinoma of the right ovary. Complete staging laparotomy was
>negative for gross disease elsewhere in the abdomen or pelvis. The
>contralateral ovary was negative for tumor by frozen section.
>

Geff,

In the UK mostly our histologists are reluctant to give a defnitive diagnosis on frozen section of ovarian lesions. They are especially reluctant to be definite about a tumour being benign. In a woam of this age there can be no advantage to conserving the uterus and other ovary ( though I admit that completing the clearance may contribute slightly to increased of postoperative morbidity ). All that can be said of the contralteral ovary is that the bit your histologist looked at wasn't malignant. I'm not clear did you take out the uterus and other ovary ? - I certainly would have done. If you did what was the value of the frozen section ? If you didn't why not ?

--
Malcolm Griffiths               MD,MRCOG,MFFP,Cert.Mgmnt
Obstetrician & Gynaecologist    Luton & Dunstable Hosp.,UK.
Tel:    01582-497459 (office)
        01525-222849 (home)
Fax:    01582-497424
email:  Malcolm@mgriff22.demon.co.uk

"It is dangerous to be right on a subject on which the established authorities are wrong." (Voltaire)





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