01-30-2010, 10:15 PM
A 37-year-old female presented to your office with an ultrasound report suggestive of bilateral ovarian masses. You take her to the operating room for an exploratory laparotomy and note the left ovary to be replaced by an 8 x 9 cm neoplastic process. The right ovary appears to have a small 2 x 2 cm cystic process, similar in appearance to the left ovary, involving only a small portion of the right ovary. After obtaining pelvic and upper abdominal washings, you remove the left ovary and then perform a cystectomy on the right ovary, removing all visible disease without rupture. The frozen section on both resected specimens reveals a serous tumor of low malignant potential (LMP). The best procedure for the patient at this point is which of the following?
A.
termination of the procedure; await final pathology report on the resected specimens
B.
total abdominal hysterectomy and right salpingo-oophorectomy
C.
omentectomy and peritoneal biopsies
D.
omentectomy, peritoneal biopsies, selected pelvic and peritoneal lymph node sampling
E.
terminate procedure and prescribe postoperative chemotherapy