Ovarian Tumours

Presentation
Asymptomatic
Lump abdomen
Pain abdomen
Dragging pain in large tumours
Acute pain in complications
Dull pain in rapid growth
Pressure symptoms
Usually bladder symptoms
Menstrual symptoms
Postmenopausal bleeding
Benign vs Malignant
Age
Pain
Pedal edema
Cachexia
Ascites
Bilaterality
Consistency
Mobility
Metastasis
Tumour markers
Differential Diagnosis
Full bladder
Pregnancy
Fibroids
Asites
Hydronephrosis
Mesenteric cysts
Hydrometra/ Hematometra/ Pyometra
Enlarged spleen
Mucocele of appendix/GB
Hydatid cysts
Investigations
USG IVU
Barium meal/enema
Tumour markers Upper/Lower GI
CT/ MRI endoscopy
Ascitic tap
Breast examination/
mammography
Hematologic & X-Ray abdomen
Biochemical inv X-Ray chest
Colour Doppler
Diagnostic
laparoscopy
EUA
 Principle of management

All ovarian tumours are to be considered

malignant unless proved otherwise !

Likelihood of malignancy in any ovarian neoplasms is 15-25%.

Even more chances in children and postmenopausal women!
Principles of management
Management of actual or suspected
ovarian neoplasms is SURGICAL
Indication for surgery
Relief of symptoms
To exclude malignancy
( Its not always possible to differentiate
between a benign and malignant neoplasm
based on history and clinical findings alone)
Principles of management
Should all ovarian enlargements be explored?

Some of them will be functional enlargements

Indications for operation

Any cyst > 7 cm in size
Any solid ovarian tumour
Any postmenopausal ovarian tumour

Role of OCPs
Type & extent of surgery
Extent of surgery at laparotomy
Nothing
Cyst excision
Unilateral oophorectomy
TAH+BSO
More radical surgery
Extent of surgery depends upon
Pathological findings at surgery & frozen section
Patients age
General health
Desire for future childbearing
 Thank you

In the last class on ovarian tumours, we

shall discuss malignant ovarian
tumours