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Ovarian cancer symptoms — DRCOG MCQ

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HardGynaecological OncologyOvarian cancer symptomsDRCOG

A 56-year-old with persistent bloating and early satiety has CA125 186 IU/mL and an ultrasound showing a complex bilateral adnexal mass. Her Risk of Malignancy Index is 340. What is the next best step?

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Correct answer: C — Arrange CT staging and refer to a gynaecological oncology team

The best answer is “Arrange CT staging and refer to a gynaecological oncology team”. An RMI of 250 or more indicates substantial ovarian-malignancy risk in the NICE pathway. CT of the abdomen and pelvis is used to assess disease extent and she should be referred to a specialist gynaecological oncology multidisciplinary team. Serial primary-care markers or cyst aspiration would delay and potentially compromise definitive assessment.

Reference: NICE CG122: Ovarian cancer recognition and initial management: https://www.nice.org.uk/guidance/cg122/chapter/recommendations