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Help in understanding CT Scan
Attn: Dr Sethi

Hi Dr Sethi,

I would be extreemly greatfull if you could assist me in trying to understand CT scan of my mother. The CT Scan has been performed as a result of CA125 marker being high 220 and result of an ultrasound have discovered a mass and the reports details are as follows:

Within the rt andexa there appears to be a complex hetrogenous mass measuring 89x61x58mm, vascular flow noted within. No normal ovarian tissue appreciated around this mass. The appearance are worrisome for ovarian pathology. The size of the mass appears to extend across to the left andexa. The left ovary appears within normal sonographic limits however visualisation is limited. Free fluid is noted within the pouch of douglas.

The anterverted uterus appears bulky with the myometrium appearing hetrogeneous. The endometrium appears irregular measuring 7mm.

The visualised areas of the liver appear coarse and hetrogenous however no obvious liver lesions seen. The gallblader appears well distended no obvious gallstones seen. The spleet both kidneys, aorta and pancreas appear within normal sonographic limits

Minimum plueral effusion noted on the rt

No abdominal scites seen.

Based on this report a CT scan has been pefrormed however no report is available for the CT scan.

I have a copy of the Ultrasound & CT scan files/images on a CD, I can partially understand the Ultrasound images and identify the mass however I am not sure how to interpret the CT scan images since there appear to be allot of things highlighted in white and hence nothing to differentiate between organs and or mass?

The scan results and blood test, have been forwarded to a team of consultants who will discuss this case on Friday 2nd.

If possible I would like to before then try to understand findings from the information I have so far, how can I determine if the mass (tumor) is benign or malignant?

Many thanks in advance
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1 Answers
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301037 tn?1213868178
Hi there
Based on your ultrasound finding they show a complex right adnexal mass and non visulaized normal ovarian tissue separtely, this along with a raised CA-125 which is a tumour marker for ovarian cancer, findings are suggestive of ovarian malignancy. Fluid in POD and pleural effusion are again points of worry.

CT scan is done to confirm this. On CT scan what we look for is the location and extent of the pelvic mass and presence of thick enhancing wall and enhancing septations point towards malignacy, u ll see the mass in the sections of the pelvis,further u need to look at the liver and peritoneal cavity for possible secondaries.
CT has been useful for detecting local tumor involvement of the pelvic ureter and uterine serosa, as well as metastases to the peritoneum, omentum, mesentery, liver, spleen, and lymph nodes. CT has a reported accuracy for ovarian cancer staging of up to 94%.

The preoperative evaluation of patients with suspected ovarian carcinoma usually includes a serum CA-125 determination. Only about 50% of all patients with ovarian cancer have a true positive result. Thus, this test alone is inadequate when used in isolation as a screening tool. However, with stage II or greater ovarian cancer, the true positive rate is as high as 80%.

However, still nothing definite can be said without looking at the scans, so ur doctor is the best judge available.


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