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Ovarian cancer suspected — MCCQE Part 1 MCQ

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ModerateAbdominal / Pelvic MassOvarian cancer suspectedMCCQE Part 1

A 64-year-old postmenopausal woman has bloating, early satiety and increased abdominal girth for 3 months. Examination reveals ascites and a fixed adnexal mass. Which of the following is the most appropriate next step?

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Correct answer: B — Pelvic imaging, CA-125 and referral to gynaecologic oncology if suspicious

Persistent bloating, early satiety, ascites and adnexal mass in a postmenopausal woman are concerning for ovarian cancer. Pap testing screens for cervical disease and does not evaluate ovaries. Referral to gynaecologic oncology improves staging and surgical outcomes when malignancy is suspected.

Reference: SOGC adnexal mass guidance; provincial gynaecologic oncology pathways