In a suspected case of ovarian cancer, imaging work up is required for all of the following except:
Ans. is c, i.e. StagingRef: Novak 14th/ed, pl477; Jeffcoate 7th/ed, p550"FIGO staging is based on finding at surgical exploration." - Ref: Novak 14th/ed, pi 477"Whenever malignancy is suspected, a staging laparotomy should be carried out." - Ref: Jeffcoates 7th/ed, p550Role of Imaging in Ovarian tumor:* Used for - delineating the site and size of lesion.* Characterization of lesion into benign or malignant.Detects early metastasis.* To assess resectability.* To exclude extraperitoneal metastasis (like liver parenchyma, enlarged pelvic and paraaortic nodes, hydroureter and hydronephrosis)Role of imaging in ovarian cancer:"TVS is typically the most useful investigation to differentiate benign tumors and early stage ovarian cancers." In patients with advanced disease, sonography is less helpful. The pelvic sonogram may be particularly difficult to interpret if a large mass encompasses the uterus, adnexa & surrounding structures. Ascites, if present is easily detected but in general abdominal sonography has limited use""CT scanning has a primary role in treatment planning for women with advanced ovarian cancer. Preoperatively CB 20). Implants, in the liver, retro peritoneum, omentum other intra-abdominal sites are detected to thereby guide surgical crypto reduction or demonstrate absolutely resectable disease. However, CT is not particularly reliable in detecting intra peritoneal disease small than 1to2cms in diameter. Moreover CT is not useful in differentiating between benign ovarian mass and malignant tumor". - Ref: Williams Gynae 3rd/ed, p742
Detection of adnexal lesion
Characterization of lesion
Staging
Assess resectability
Carcinoma Ovary