1. Apart from a positive family history of breast, bowel or ovarian cancer, what are the other risk factors that can increase the chances of developing ovarian cancer?
2. Phillipa presented with intermittent lower abdominal pain, followed by bloating, indigestion, feeling full after eating and urinary urgency and frequency. She tells you that she has no children but is in a long-term relationship. She remembers her mother had breast cancer when she was 45 years old and her paternal grandmother had some sort of abdominal cancer when she was in her 70s. Phillipa does not know whether this was bowel cancer or a gynaecological cancer. You examine her abdomen, which feels full but you do not feel a mass. PV reveals a firm mass in the Pouch of Douglas. To check if this is faeces you also do a PR, but her rectum is empty.
Question: a) What investigations would you request? b) Would you order CA125? Why? c) Name 5 causes of raised CA125.
1 comment:
1) risk factors:
- age
- obesity
- reproductive history
- fertility drugs
- androgens
- hormone replacement therapy
- diet
2)Investigations
- ultrasound pelvis
- ca 125
3)other causes of raised ca125
- pregnancy
- endometriosis
- fibroid
- menstruation
- pelvic inflammatory disease
- pancreatitis
- benign ovarian tumour for eg. ovarian cysts
- fertility drugs
- other malignancies for eg. breasts or lungs
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