Preoperative evaluation of ovarian masses: ultrasound and biochemical screening

The preoperative study of an ovarian mass, with a negative dosage of plasmatic BhCG, mainly has the purpose of discriminating between a benign neoplastic mass and a malignant mass. The aim of our work was to evaluate the validity of preoperative screening including a pelvic ultrasound examination and the dosage of some plasmatic tumor markers.

This is a retrospective study conducted on 78 patients who were referred to the III Division of the Department of Gynaecological Sciences, Perinatology and Puericulture of Rome University "La Sapienza" from January 1st 2001 to December 31st 2001 with a diagnosis of ovarian tumefaction whose origin was still to be determined. These patients underwent both a transabdominal and transvaginal ultrasound scan and biochemical examination of serum levels of Ca-125, Ca 19-9 and CEA. Subsequently these patients underwent surgery or medical therapy according to the suspected diagnosis. We then compared our suspected diagnosis with the precise histological diagnosis. Finally, following this comparison, we judged the validity of the proposed screening.

Ultrasound examination is on its own an excellent method for preoperative screening in cases of adnexal tumefactions. However, its association with plasmatic dosages of Ca 125, Ca 19-9 and CEA improves the validity of the screening.

The use of pelvic scanning, both transabdominal and transvaginal, associated with plasmatic dosages of Ca 125, Ca 19-9 and CEA, represents an excellent method of preoperative screening for the evaluation of benign or malignant ovarian tumefactions and for directing the surgeon towards the best therapy.