Abdominopelvic CT scan findings after surgery for ovarian cancer.
OBJECTIVE
To evaluate abdomino-pelvic changes in patients who had total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) for stage I ovarian cancer.


METHODS
The postoperative computed tomographic (CT) scans of 23 patients who had undergone TAH and BSO for stage I ovarian tumours between 3 and 14 weeks previously were assessed, providing there had been no treatment with chemotherapy or radiotherapy and that each patient had normal tumour marker (CA125) levels after surgery. After the CT scan patients were followed up and had no clinical or biochemical (CA125) evidence of relapse for a median of 27 months (range 11 to 78 months). The following sites were assessed by two observers: the vaginal vault, round ligaments, bladder, rectum, perirectal fat, pelvic sidewalls, omentum, surgical scar and abdominal wall. Any abnormality was recorded, with re-evaluation on follow-up CT scans in ten patients (between three and 17 months).


RESULTS
The following abnormalities were seen: (1) Thickened round ligaments (n=12) with bulbous masses at the surgically transected ends (n=7). This was bilateral in eight patients. (2) Vaginal vault thickening (n=11) either uniform (n=6) or bulbous bilaterally (n=2) or unilaterally (n=3). (3) Subtle omental bed stranding or nodularity (n=11). (4) Peritoneal thickening underlying the scar (n=4). (5) Asymmetrical rectus abdominis muscles (n=3) adjacent to the surgical scar or thickened scar tissue in the anterior abdominal wall (n=4). No significant bladder, rectal, perirectal or nodal abnormalities were found.


CONCLUSIONS
Pseudotumours at the transected ends of the round ligaments, or uniformly swollen round ligaments, may be identified in patients who have had TAH and BSO, as may vaginal vault thickening. Other changes which may be observed in the abdomen and pelvis are peritoneal thickening adjacent to the scar and omental bed stranding.
Razzaq
R
R
Department of Diagnostic Radiology, Christie Hospital NHS Trust, Manchester, UK.
Carrington
B M
BM
Hulse
P A
PA
Kitchener
H C
HC
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010052:Ovariectomy; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging; D010388:Pelvis / Q000000981:diagnostic imaging*; D011184:Postoperative Period; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed