Preoperative sonography of malignant ovarian neoplasms.

Patient survival in malignant ovarian tumors is directly dependent on complete surgical resection. This can be best accomplished when the surgeon is informed of tumor extent preoperatively. We retrospectively studied the preoperative sonograms of 32 patients with proven malignant ovarian tumors. Results were compared with the surgical and pathologic findings. Sonography was 97% accurate in the detection and 84% accurate in the characterization of the pelvic masses; 87.5% of these tumors were malignant by sonographic criteria. Sonography correctly staged only 48% of patients. Bowel and bladder involvement, of major importance in planning surgical treatment, were not detected by sonography. A uterus inseparable from a pelvic mass correlated with uterine involvement in 74% and this information alone may prevent laparotomy by surgeons unprepared to perform the complete resection necessary for optimum survival.