Abdominopelvic CT scan findings after surgery for ovarian cancer

Aims: To evaluate abdomino-pelvic changes in patients who had total abdomin al hysterectomy (TAR) and bilateral salpingo-oophorectomy (BSO) for stage I ovarian cancer. Method: The postoperative computed tomographic (CT) scans of 23 patients wh o had undergone TAH and BSO for stage I ovarian tumours between 3 and 14 we eks previously were assessed, providing there had been no treatment with ch emotherapy or radiotherapy and that each patient had normal tumour marker ( CA125) levels after surgery, After the CT scan patients were followed up an d had no clinical or biochemical (CA125) evidence of relapse for a median o f 27 months (range 11 to 78 months), The following sites were assessed by two observers: the vaginal vault, roun d ligaments, bladder, rectum, perirectal fat, pelvic sidewalls, omentum, su rgical scar and abdominal wall. Any abnormality was recorded, with re-evalu ation on follow-up CT scans in ten patients (between three and 17 months). Results: The following abnormalities were seen: (1) Thickened round ligamen ts (a = 12) with bulbous masses at the surgically transected ends (n = 7). This was bilateral in eight patients, (2) Vaginal vault thickening (n = 11) either uniform (n = 6) or bulbous bilaterally (rt =2) or unilaterally (n = 3), (3) Subtle omental bed stranding or nodularity (a = 11), (4) Peritonea l thickening underlying the scar (n=4). (5) Asymmetrical rectus abdominis m uscles (n=3) adjacent to the surgical scar or thickened scar tissue in the anterior abdominal mall (n=4). No significant bladder, rectal, perirectal o r nodal abnormalities were found, Conclusion: Pseudotumours at the transected ends of the round ligaments, or uniformly swollen round ligaments, may be identified in patients who have had TAH and BSO, as may vaginal vault thickening, Other changes which may b e observed in the abdomen and pelvis are peritoneal thickening adjacent to the scar and omental bed stranding.