Patient underwent abdominal hysterectomy +BSO with omentectomy

Discussion in 'Plab 1 and 2 forum' started by Partha Sarkar, Feb 20, 2013.

  1. Patient underwent abdominal hysterectomy +BSO with omentectomy for CA Ovary came for follow up. CA 125 normal levels after surgery. Best inv?

    Pelvis usg
    pelvic CT
    CA 125
    CA 153
    Laparotomy
    laparoscopy
    paracenthesis
  2. Why would a CT seem too extreme? This is a patient that's undergone a massive surgical procedure, which already implies that an invasive tumour was removed.
    CA125 has too many false negatives to use it as a "screening" method. You use it as a follow up because you check how the levels go down, and if it doesn't decrease or rises it's sign that there's something wrong, but when you have a negative result, you can't say the patient is disease free
    A "second look" surgery should be avoided if you have a reliable imaging method.
    USG is not diagnostic tool of choice to R/O metastasic disease, and neither is paracentesis.

    So, basically, CT is the only option valid here (and, from the little I know of oncology, it's what they actually do).

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