QuestionSBA
QuestionChoice
This is an ultrasound scan feature that scored 1 point in the RMS.

Ultrasound result is based on how malignant the mass appears. Complex, multiocular has a more complex appearance with multiple septae within the cyst, this suggests it is more likely to be cancerous.

Be aware that a benign lesion is more likely to be unilateral and look uniocular/ simple on ultrasound, this means that they are uniformly thin-walled with a single cavity. Benign lesions are likely to be smooth, well-circumscribed and are not able to spread.
10005809
d
Complex, multiocular cysts on ultrasound scan
QuestionChoice
Levels over 35U/ml may indicate the presence of cancer within the body and are most associated with ovarian cancer.

This can be raised in pre-menopausal women due to conditions other than ovarian cancer such as endometriosis and pregnancy.

This marker should not be used in isolation when assessing the risk of ovarian cancer. Therefore is combined with menopausal status and ultrasound features to produce the risk score.
10005807
b
Ca-125
QuestionChoice
The risk of Malignancy index (RMI) is a combined score that predicts the risk of an adnexal mass being malignant.

It includes a raised Ca-125 (the ovarian cancer marker), menopausal status and ultrasound scan features. These are then multiplied together to determine the risk and best next steps for investigations of the patient.

As with most cancers, the risk of ovarian cancer does increase with age but the majority develop after menopause which is a better predictor.
10005806
a
Age
QuestionChoice
Most cases of ovarian cancer happen in those that have already gone through menopause.

The definition of a post-menopausal female has not had a period for more than 12 months. The average age is 50 years old.

Pre-menopausal women score 1 point, post- menopausal score 3 points.
10005808
c
Menopausal status
QuestionChoice
This is a USS feature that is highly suggestive of malignancy.
10005810
e
Metastases on ultrasound scan
Concept
Chapter
2693
3843
Ovarian cancer
Topic
176
Gynaecology
13708
A 56 year old, post-menopausal woman presents with early satiety, bloating and weight loss.

The GP wants to rule out Ovarian cancer and intends to work out a (Risk of Malignancy Index) RMI score.

Which of these factors are not included in the Risk of Malignancy score?
a