Ovarian Cancer: The Daily PANCE Blueprint
A 55-year-old female presents to the clinic with 20lb weight loss, lower pelvic pain, and worsening bloating. Which of the following would be the best initial test?
A. MRI of abdomen/pelvis
B. Pelvic ultrasound
C. Abdominal x-ray
D. PET scan
E. CA-125 level
Answer and topic summary
The answer is B. Pelvic ultrasound
Ovarian cancer is the most deadly gynecological neoplasm in the U.S. The various types include epithelial (MC), germ cell, and stromal cell tumors. Clinical features include: changes in urination, bloating, early satiety pelvic pain, post-menopausal bleeding, malignant pleural effusions, ascites, lymphadenopathy, headaches, etc. Pelvic ultrasound is the imaging test of choice. CA-125 is a tumor marker elevated in 80% of malignant tumors (it should be used only to monitor disease progression or recurrence).
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