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Investigations

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  • routine haematologic and biochemical studies

  • abdominal radiograph - calcifications in a younger patient may be due to a benign cystic teratoma, the most common neoplasm in patients under 25 years

  • barium enema - to rule out ovarian metastases from a primary colonic cancer in older patients

  • breast mammography - in patients with suspicious breast lumps to eliminate breast metastases

  • pelvic ultrasonography, especially transvaginally - more effective than CT as provides information which is predictive of cancer. Unilocular cystic masses are generally, benign cysts; predominantly solid or multilocular masses are likely to be neoplastic

  • serum tumour markers - CA-125 is elevated in 80% of patients with advanced ovarian cancer. But this marker may also be elevated other cancers and non-malignant conditions (see menu).
  • endometrial biopsy - if abnormal vaginal bleeding - to exclude concurrent primary endometrial and ovarian tumours

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