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
  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).

Share This Page