title: Postmenopausal palpable ovary and ovarian cancer.
abstract: BACKGROUND
  Ultrasound (US) examination is a much more reliable method for evaluation of potential ovarian cancer risk than gynecologic palpation. The aim of our study was to analyze the US characteristics of patients with palpable ovaries in light of potential for malignancy.
  
  
  METHODS
  We analyzed 70 women ten years after menopause without increased CA 125 values. They underwent clinical and US exams (abdominal and transvaginal ultrasound), with special emphasis on US Doppler exam.
  
  
  RESULTS
  Bimanuel gynecological examination showed palpable ovaries in 14 patients (palpable ovary group), and the remaining 56 patients were defined as the control group. US showed increased dimensions of palpable ovaries. Atypical follicular activity, deviation from verticalization, atypical ovaries and hyperechogenic punctations classified under germ cell cysts occurred statistically significantly more often in the palpable ovary group. Doppler flow showed pathological vascularization in five patients with palpable ovaries and the estrogen level was increased. After four to six months in these five patients we found a mild increase of estrogen levels and higher Doppler abnormality. Six months later, two patients had irregular bleeding and underwent surgical treatment.
  
  
  CONCLUSIONS
  Every adnexal mass after menopausis demands special attention. Bimanuel gynecological exams should be used liberally. It is necessary to follow the dimensions of the ovary, describe the echostructure, as well as the edges of the ovary and other anatomical structures. Doppler flow measurement and estrogen levels are predictive and give more information. Controls should be in three to six month intervals in order to make a decision for surgical treatment.
authors: School of Medicine, University of Belgrade, Belgrade, Serbia. miroslavagojnicdugalic@yahoo.com
authors: M
authors: M
authors: Gojnić
authors: M
authors: M
authors: Branković
authors: M
authors: M
authors: Maksimović
authors: B
authors: B
authors: Parapid
authors: V
authors: V
authors: Dugalić
authors: K
authors: K
authors: Jeremić
authors: B
authors: B
authors: Gutić
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D016022:Case-Control Studies; D004967:Estrogens / Q000097:blood; D005260:Female; D058869:Gynecological Examination; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010048:Ovarian Cysts / Q000175:diagnosis; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D010173:Palpation; D018608:Ultrasonography, Doppler
chemical_list: D004967:Estrogens