WOMEN WITH A PELVIC MASS - WHEN TO PERFORM AN ULTRASOUND

A retrospective study of 264 patients with a pelvic mass who had a pre operative serum CA 125 level performed was undertaken to compare the s ensitivity, specificity and predictive values of this test as a predic tor of malignancy, compared with clinical impression and ultrasonograp hy (USG). The values were calculated for each parameter alone and in c ombination, and the effect of menopausal status, histological type and stage of disease was also assessed. The results indicate that in post menopausal women with a pelvic mass, a CA 125 level should be performe d and the patient referred to a gynaecological oncologist if the value is raised. In contrast both CA 125 and USG should be performed in the premenopausal woman to allow appropriate referral. In this study a CA 125 level of 35 u/ml or more correctly identified malignancy in 90% o f postmenopausal women.