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Pelvic Mass Case Studies

Pelvic Mass Case Studies. Oct. 2, 2001 -- Jorge Garcia, MD. Case 1.

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Pelvic Mass Case Studies

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  1. Pelvic Mass Case Studies Oct. 2, 2001 -- Jorge Garcia, MD

  2. Case 1. • A healthy 36 y.o. advertising executive presents for PAP smear, due 2 ½years ago, complaining of bloating. Exercises nearly every day, deniesweight loss, and no other symptoms. States that “pants don’t fit wellanymore.”PMHx: negativeROS: neg. except new constipation.Exam: thin, comfortable, abdomen normal. Bimanual: easily palpatednormal uterus, but unable to feel adnexa. What would you do now?

  3. Case 2. • A healthy 68-year-old presents for exam, worried about cancer. She has afriend that was just diagnosed with ovarian ca, and a sister that hadbreast cancer at age 73. PMHx and FHx otherwise normal. Her exam was entirely normal.

  4. Case 2. • What do you do next?What is her risk of ovarian cancer?How does her family history influence the risk?How can you reduce this risk?How can you reduce her risk of dying with this cancer?What are her biggest health risks, in order?

  5. Case 3. • A healthy 72-year-old woman presents for a routine complete physicalexam. She has no symptoms. PMHx is negative. She is G3/P2/SAB1.Exam: right ovary is palpable, but “small” and non-tender.What do you want to do next?Is a bimanual a good screening test?

  6. Case 4. • A 48-year-old over ideal weight but otherwise healthy woman presents with3 days of spotting and left pelvic pain. History of irregular periods forsix months. PMHx: G4/P3; s/p tubal ligation ~6 years ago. Smokes 1 PPD/20 years.Exam: 98/60 98.8 110 22Abd: Decreased BT, mild lower left side tenderness w/o guarding/rebound.Cx. appears healthy. Left adnexal tenderness, and mild CMT.What would you do next?

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