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Management of Ovarian Masses in Premenopausal Women (GTG 62 - Nov 2011),…

- - - - Unreliable in differentiating benign from premalignant ovarian masses in pre-menopausal women due to high false-positive rate and poor specificity
      - Raised in several conditions: Fibroids, endometriosis (stage III-IV), adenomyosis, pelvic infection
      - Primarily a marker for epithelial ovarian carcinoma and is only raised in 50% of early disease
      - NOT necessary when clear ultrasound diagnosis of a simple ovarian cyst has been made
      - If >200: discuss with gynae-oncologist
        If <200: Investigate to exclude differentials
        Serial monitoring may be helpful as rapidly rising levels are more likely to be malignancy than levels that remain static
    - - Measure in women under 40 with a complex ovarian mass due to possibility of germ cell tumours
    - - Single most effective way of evaluating an ovarian mass
      - TVS has greater sensitivity over TAS
      - No single ultrasound finding differentiates between benign and malignant masses
    - - Routine use does not improve sensitivity or specificity obtained by transvaginal ultrasound
      - Useful in evaluating more complex lesions