A 25 year old married nullipara undergoes laproscopic cystectomy for ovarian cyst which on histopath reveals ovarian serous cisadeno-carcinoma. What should be the next management ?
Ans. is a i.e. Serial Ca 125 measurement and follow up Here the patient is 25 years old nullipara and cystectomy sample shows serous cysadeno carcinoma - Probably the disease is limited to the ovary removed, hence to be called stage la. Doing an ovariotomy here will suffice as the patient is young and nullipara is to be followed the patient with regular CA 125 estimations. Though the levels of CA 125 are not specific but in this condition where the follow up is after a known cause there is ample sensitivity. "Feility preservation in early stage ovarian cancer - The uterus and the contralateral ovary can be preserved in women with stage la, grade 1 to 2 disease who desire to preserve feility. The conditions of the women should be monitored carefully with routine periodic pelvic examination and determinations of serum CA 125 levels. Generally, the other ovary and the uterus are removed at the completion of childbearing."
Serial Ca-125 measurement and follow up
Hysterectomy and bilateral ping000phorectomy
Hysterectomy + Radiotherapy
Radiotherapy