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#90 Bedside POCUS ultrasound: an accurate diagnostic tool for gynecological malignancy
  1. Rostyslav Bubnov
  1. Clinical hospital `Pheophania`, Kyiv, Ukraine


Introduction/Background Point-of-care ultrasound (POCUS) has gained recognition as a valuable diagnostic tool due to its accessibility, real-time imaging capabilities, and non-invasive nature.

Methodology We present the case of a 75-year-old female patient with a history of cervical cancer. The patient had progressed to stage IVb, with documented metastasis to the lungs and lymph nodes. After completing one course of polychemotherapy, the patient reported experiencing abdominal pain. Recognizing the urgency, a bedside emergency ultrasound examination was performed using POCUS.

Abstract #90 Figure 1

Upper - a cystic-solid-cystic formation near the bottom of the uterus, where the patient reported pain; lower - TV expert US visualized cervix solid lesion measuring 44 x 38 x 40 mm

Results The POCUS revealed that the patient‘s uterus was significantly enlarged, with diffuse focal changes in both the body and cervix, and a cystic-solid-cystic formation in the area of the right appendages and near the bottom of the uterus, where the patient reported experiencing pain. The solid component of the formation measured 53x56x60mm, while the two cystic components measured 80x75mm and 90x77mm, respectively. There was evidence of fluid in the abdominal cavity.

Expert ultrasound examination was then performed, including transvaginal, and it revealed lesion in the pelvis of the right appendages, and a lesion in the spleen. Retroperitoneal lymphadenopathy, signs of nephropathy, and signs of cholestasis were also observed both on POCUS and expert ultrasound.

Additionally TV expert US visualized cervix solid lesion measuring 44 x 38 x 40 mm with abundant blood flow that was difficult to identify a in the cervix using transabdominal access during POCUS.

Subsequent CT and MRI scans confirmed the ultrasound findings, and a definitive diagnosis of gynecologic malignancy was made. The accuracy of the ultrasound diagnosis, particularly the POCUS, played a crucial role in identifying the right appendage lesion in the patient and adjusting her treatment plan accordingly.

Conclusion This case report underscores the value of POCUS in emergency situations and highlights the importance of expert interpretation of ultrasound results in providing accurate diagnoses for patients with gynecologic malignancies.

Disclosures None

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