Cystic lesions in elderly women, diagnosed by ultrasound.
ABSTRACT A retrospective review of an entire clinical series of 152 women over 50 years of age, in whom cystic lesions without solid parts had been diagnosed by ultrasound, found there were no malignancies in 58 completely anechoic lesions less than 5 cm in diameter. Of 10 small lesions (less than 5 cm in diameter) with some echogenicity or septa, one was a borderline tumour. In contrast, in patients with lesions greater than 5 cm in diameter there were three malignancies in the group of 33 totally anechoic cysts, five in the group of 32 cysts with some echogenicity, and as many as eight malignancies in the 18 lesions where several septa were present. Two borderline and one malignant tumour had been missed at previous clinical examination. We conclude that small anechoic lesions are seldom, if ever, malignant in elderly women. Sonography is helpful in patients with a negative clinical examination when pelvic pain or signs of malignancy are present.
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ABSTRACT: Context: Although there have been reports of increasing incidence of ovarian cancer in developing countries, no developing country has been involved in current trials of ovarian cancer screening. Aim: To review the evolution of the role and drawbacks of ultrasonography in ovarian cancer screening and the feasibility of implementing current potential screening strategies inlow resource settings. Methods: An electronic literature search for all articles written in English language on ovarian cancer screening from 1960-2013. Information from appropriate articles were collated and analysed for content. Results: Ultrasound was used as the first-line or secondline test in the most popular multicentre multimodal trials of ovarian cancer screening. It has a high sensitivity but a low specificity. The low specificity of ultrasound screening necessitates the use of further measures to aid the triaging of ultrasound positive cases, which add to the overall cost of screening. There is yet scant evidence of the cost effectiveness of multimodal screening for ovarian cancer. Current potential strategies for ultrasound-based screening for ovarian cancer demand the training and employment of large numbers of highly skilled personnel as well as the acquisition of high resolution scanners and technology for biochemical assay of tumour markers. Conclusion: Transvaginal ultrasonographyhas evolved into a potentialtool for ovarian cancer screening and ovarian cancer screening strategies based on CA125 assays and ultrasonography would demand substantial resources. If and when reduction in mortality and cost-effectiveness of this approach to screening are proven, itmay not be feasible in developing countriesAmerican Journal of Clinical Medicine Research. 01/2015; 3(1):1-8.
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ABSTRACT: Conclusio a. Die properative Diagnostik sollte ein kombiniertes, sowohl abdominales als auch vaginales Vorgehen beinhalten. b. Sonographische Dignittskriterien drfen nicht isoliert betrachtet werden. Immer mu auch die Relation zum klinischen Gesamteindruck bercksichtigt werden. c. Als Grundlage fr eine minimalinvasive Chirurgie sollte stets das Abwgen von geringerer Operationsbelastung fr eine Patientin gegen die Wahrscheinlichkeit, eine maligne Erkrankung ungengend zu behandeln, dienen. d. Sonographische scheinen sich drei Malignittsklassen unterscheiden zu lasse: Die „simple Ovarialzyste“, der vermutlich „benigne Adnextumor“ und der vermutlich „maligne Adnextumor“.Archives of Gynecology and Obstetrics 12/1993; 254(1):1207-1214. · 1.28 Impact Factor
- Journal of Obstetrics and Gynaecology 09/1992; 12(5):312-313. · 0.60 Impact Factor