60-year-old woman presented to the Emergency Room with 1-week history of abdominal pain, the ultrasound…

الشرح

Core Concept: A complex, multiloculated, solid adnexal mass in a postmenopausal woman with significantly elevated CA-125 is highly suspicious for epithelial ovarian carcinoma. Clinical Presentation: Abdominal pain, bloating, early satiety, pelvic mass, and weight loss. Diagnosis: First-line imaging is transvaginal ultrasound showing complex features (solid components, thick septations, ascites). The gold standard for definitive diagnosis and staging is surgical exploration with histopathological examination. Management: Acute management involves a comprehensive staging workup (CT chest/abdomen/pelvis). The gold standard definitive management is referral to a gynecologic oncologist for optimal surgical cytoreduction (debulking) and staging, followed by platinum-based chemotherapy. Aspiration or simple cystectomy is strictly contraindicated due to the high risk of tumor seeding, rupture, and upstaging the cancer.