Pelvic masses

Jump to: navigation, search
Pelvic masses

WikiDoc Resources for Pelvic masses

Articles

Most recent articles on Pelvic masses

Most cited articles on Pelvic masses

Review articles on Pelvic masses

Articles on Pelvic masses in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Pelvic masses

Images of Pelvic masses

Photos of Pelvic masses

Podcasts & MP3s on Pelvic masses

Videos on Pelvic masses

Evidence Based Medicine

Cochrane Collaboration on Pelvic masses

Bandolier on Pelvic masses

TRIP on Pelvic masses

Clinical Trials

Ongoing Trials on Pelvic masses at Clinical Trials.gov

Trial results on Pelvic masses

Clinical Trials on Pelvic masses at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Pelvic masses

NICE Guidance on Pelvic masses

NHS PRODIGY Guidance

FDA on Pelvic masses

CDC on Pelvic masses

Books

Books on Pelvic masses

News

Pelvic masses in the news

Be alerted to news on Pelvic masses

News trends on Pelvic masses

Commentary

Blogs on Pelvic masses

Definitions

Definitions of Pelvic masses

Patient Resources / Community

Patient resources on Pelvic masses

Discussion groups on Pelvic masses

Patient Handouts on Pelvic masses

Directions to Hospitals Treating Pelvic masses

Risk calculators and risk factors for Pelvic masses

Healthcare Provider Resources

Symptoms of Pelvic masses

Causes & Risk Factors for Pelvic masses

Diagnostic studies for Pelvic masses

Treatment of Pelvic masses

Continuing Medical Education (CME)

CME Programs on Pelvic masses

International

Pelvic masses en Espanol

Pelvic masses en Francais

Business

Pelvic masses in the Marketplace

Patents on Pelvic masses

Experimental / Informatics

List of terms related to Pelvic masses

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Epidemiology and demographics

Pelvic masses are most commonly found in women, pelvic masses can also occur in men. Cases besides bladder distension and pregnancy need to be ruled out before workup. Consider every case as a malignancy. As age increases, so does the liklihood that malignancy could be a cause.

Differential Diagnosis

In alphabetical order: [1] [2]

Diagnosis

History and Symptoms

  • Determine whether the mass is painful

Physical examination

Abdomen

  • Full abdominal exam
  • Full pelvic/genital exams (bimanual & rectal)

Other

  • Full breast exam
  • Full lymph node exam

Laboratory Findings

  • Labs include:
  • BUN/creatinine
  • CBC w/ differential
  • Culture for gonorrhea and chlamydia
  • Hemoccult testing
  • Liver function tests
  • Pap smear
  • Urinalysis

Electrolyte and Biomarker Studies

  • Tumor markers if ultrasound is abnormal

MRI and CT

  • Pelvic CT
  • Abdominal CT

Echocardiography or Ultrasound

  • Pelvic ultrasound for masses in the uterus to determine existence, size & composition.

Other Diagnostic Studies

  • Colonoscopy to exclude colon cancer
  • Bladder catheterization if culprit may be bladder distension


Treatment

Acute Pharmacotherapies

  • Hypoestrogenic medications

Indications for Surgery

  • Premenopausal ovarian mass
  • Ovarian cyst
  • observe 4-6 weeks
  • suppress with OCP
  • Consider laparoscopic procedure
  • If ovarian solid mass, complex cyst, ascites are indicated, surgical evaluation is necessary
  • Postmenopausal ovarian mass
  • <3 and asymptomatic and a normal exam indicates serial ultrasounds
  • if persistent, evaluate for surgery
  • In the event that the cyst is >3 and is symptomatic, perform laparoscopy
  • Leiomyoma
  • Consider myomectomy instead of hysterectomy

Referrals

  • Premenarchal ovarian masses - high malignancy potential; immediate gynecologic referral

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X




Linked-in.jpg