5) A 65-year-old woman is referred urgently with weight loss, abdominal bloating
and urinary urgency. An ultrasound scan demonstrates a multicystic mass
with solid areas and ascites. Her serum CA125 is 100 IU/l. A CT scan confirms
a suspicious mass. Which management should be recommended by the
multidisciplinary team?
Explanation
RMI is calculated as: U × M × CA125 (see question 301 for details). This woman’s
RMI is 3 × 3 × 100 = 900.
All ovarian cysts that are suspicious of malignancy in a postmenopausal
woman, as indicated by an RMI of ≥200, CT findings, clinical assessment or
findings at laparoscopy, require a full laparotomy and staging procedure.