Zur Diagnostik von benignen und malignen Ovarialtumoren*

Abstract

The present paper reports on the value of gynecological-clinical examinations and preoperative ultrasonography in the diagnosis of benign and malignant ovarian tumors. Out of a group of 42 patients, in all of whom "ovarian cyst" had only been diagnosed clinically, 14% were not found to be suffering from this condition at surgery. In a comparison of preoperative gynecological-clinical and ultrasonographic findings (in 68 patients) it proved possible to determine the side on which the tumor was localized, its actual size, the extent to which it was delimited from the uterus, and its consistency (whether solid or cystic) significantly better by ultrasonography (p less than 0,01). However, the results of this study indicate that 2% of the cases diagnosed ultrasonographically as "benign ovarian tumor/ovarian cyst" are likely to be ovarian carcinomas. In the group of patients with malignant ovarian tumors also (42 patients), there was a significant difference in the preoperative diagnosis "suspected ovarian carcinoma". On the basis of clinical findings it was only diagnosed in 45%, while it was found in 74% by ultrasonography (p less than 0,01). In 3 cases with ovarian carcinoma there was no pathologic palpation finding, and in only one other case was a "suspected ovarian cyst" diagnosed. By means of ultrasonography, on the other hand, all of the cases of ovarian carcinoma were classified either as "ovarian carcinoma" or as "cystic-solid/complex abdominal tumor". The most frequent diagnoses on the basis of the sonographic scan (approx. 90%) were cystic-solid ovarian tumors, followed by cystic-ventriculated ovarian tumors with solid portions and finally solid ovarian tumors with only a few cystic portions.(ABSTRACT TRUNCATED AT 250 WORDS)

Pelviscopic Treatment of Ovarian Cysts in Premenopausal Women

“…According to Schmidt [11], an ovarian carcinoma was suspected in 74% of 72 patients by preoperative sonogra phy, in 45% by clinical examination. 50% of the malig nant tumors contained echodense components, 29% were multilocular, and 1 cyst (2%) was unilocular.…”

Gibt es prä- und intraoperative Kriterien zur Vermeidung des laparoskopischen „Anoperierens” von frühen Ovarialkarzinomen oder Borderline-Tumoren?

“…eines Borderline-Tumors gibt. Diese Behauptung wird durch andere Studienergebnisse gestützt [5,7,8,14,20,21,23].…”

“…Bezüglich der Art der Behandlung von Ovarialtumoren konnte bislang keine Einigkeit erzielt werden. Dies liegt zum einen daran, daß die uns derzeit zur Verfügung stehenden prä-und intraoperativen Kriterien [3,5,7,8,14,20,21,22,23] allesamt ungeeignet sind zur Vorhersage der Dignität eines Ovarialtumors. Andererseits ist die Frage der Prognoseverschlechterung durch Eröffnung eines Ovarialkarzinoms oder Borderline-Tumors noch ungeklärt [1,4,9,11,13,15,18].…”

Accuracy of bimanual palpation versus vaginosonography in determination of the measurements of pelvic tumors

“…Several studies have investigated the value of sonography in the detection of uterine and ovarian tumors, and the assessment of their nature and extent [1, 3,6,7].…”