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Ultrasound also plays a very limited role in ovarian tumor staging. The staging accuracy of ovarian neoplasms by ultrasound is poor (48). Pelvic ultrasound examinations can show the size and local extent of the tumor, involvement of the contralateral ovary, uterine or bladder invasion, and local peritoneal spread. The presence of a uterus inseparable from an ovarian mass (Fig.

35B Free Chubby Tube Videos Granny at Fig. 35C) correlated with uterine involvement in 74 of the cases, whereas the presence of a uterus separable from an ovarian mass correlated with a lack of uterine involvement in 93 of the cases. The predominant method of local spread from cervical carcinoma is by direct extension to the distal ends of the ureters and Free Chubby Tube Videos Granny at bladder base.

Encasement of the ureters by metastases to the retroperitoneal and common iliac lymph nodes is also a common path of spread to the urinary system. Hydronephrosis along with deterioration of renal function consequently develops. Griffin and co-workers 108 found that 7. 3 of their patients with carcinoma of the cervix demonstrated incomplete ureteral obstruction causing hydronephrosis or complete ureteral obstruction with nonvisualization of the kidney on EU.

Van Nagell and co-workers 109 reported that 2. 8 of patients with stage I disease had obstructive uropathy demonstrated on EU. The incidence of ureteral obstruction was 32 in patients with stage III disease. Patients with ureteral obstruction also have an unfavorable prognosis, with a 5-year survival of 18.


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