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Indicators of a malignant lesion

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Signs of malignancy may be difficult to detect early. They include:

  • persistent or progressive ovarian enlargement in a young women - functional cysts are rarely larger than 8 cm in diameter and tend to regress during the subsequent menstrual cycle
  • palpable ovaries in a post-menopausal women - expect the ovaries to be atrophic 2 years post-menstruation
  • irregular, nodular, partially solid mass, usually bilateral and fixed
  • ascites - never in benign lesions except for a fibroma

Features from spread to other organs may include:

  • constipation - from bowel obstruction
  • hydronephrosis - from ureteric obstruction
  • uterine or vaginal bleeding - from erosion
  • lower limb oedema - from thrombosis of the inferior vena cava or an iliac vein
  • pleural effusion - from distant metastasis

Occasionally, various paraneoplastic syndromes:

  • humorally mediated hypercalcaemia - associated with clear cell tumours
  • cerebellar degeneration - associated with antibodies to Purkinje's cells
  • seborrhoeic dermatitis - Leser-Trelat's sign

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