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associated with abdominal pain. No history of yellowness of eyes, leg swelling or cough. There is an associated history of weight loss. No family history of similar occurrence or family history suggestive of BOC, LYNCH 2. Abdomino-pelvic ultrasound/Doppler revealed huge multiseptated, abominopelvic mass with both solid and cystic components and flow on colour Doppler imaging. The computed tomography scan revealed features in keeping with a Giant left ovarian mucinous cystadenocarcinoma with some ascites. The patient underwent staging laparotomy with optimal debulking surgery. Unilateral resection of ovarian tumour was done enboc, total weight 15.1kg The fine needle aspiration cytology of ascitic fluid done noted smear consisted of sheets of dysplastic cells with hyperchromatic nuclei. The cytoplasm of some cells were distended with mucin giving a signet ring appearance in a necrotic background. Her postoperative course was unremarkable. She subsequently had adjuvant chemotherapy and is presently on follow up. The main objective is to call attention to ovarian epithelial tumours within this age group in the outpatient clinics and primary care services. Thus contributing to the decrease in underdiagnosis, misdiagnosis, and underreporting that might occur.

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Electronic poster abstractsappear like a solid mass with irregular borders with eterogeneous echogenicity, highly vascularised at power Doppler investigation. Bowel volvulus was suspected by abnormal morphology of visceral wall, by intestinal contents and by clinical symptoms. Conclusions: Not only can the genital tract be visualised during TVU, but with this imaging method it is possible to visualise other pathological conditions as well, including those unrelated to gynecology. EP29.13The role of uterine artery pulsatility index and a new ultrasound-guided approach to uterine biopsy in the preoperative evaluation of placental site trophoblastic tumour

Objectives: To analyse the cases of falsely positive adnexal tumours suspected of malignancy in the application of the International Ovarian Tumour Analysis (IOTA) ADNEX, analysing the factors involved in the erroneous suspicion. Methods: Retrospective study conducted from March 2017 to March 2019 in the specific gynecological ultrasound unit of a gynecological oncology reference centre, where all cases of adnexal tumour which are suspected of malignancy were analysed. The scans were performed by the same sonographer expert, with IOTA certification. We analysed those cases considered high risk of malignancy (greater than 20%) in which the intraoperative pathological anatomy was benign, comparing them with those tumours considered low risk that were true negative, using the chi square test. Results: 274 women were included in the study period. 60% (166) who were classified as low-risk tumours: 97% (84) pathological anatomy confirmed the findings and 3 (3%) were malignant. 39% (108) were classified as high-risk tumours, which was confirmed in 68% (72) of the cases and 33 (31%) were benign. Analysing these 33 benign tumours, the average age was 60 years. When comparing false positives and true negatives, we observed an elevation of the Ca125 marker in 36% vs 7.2% (OR 7.2, p = 0.000); Regarding echogenicity, we observed 54% of solid tumours between false positives and 15% of true negatives (OR 6.6, p = 0.000), being 33% vs 1.2% in the case of solid multilocular. A Doppler score equal to or greater than 2 was found in 70% of the FP with respect to 20 of the VN (OR 8.7, p = 0.000). The most frequent resulting histological type was ovarian fibroma (39%). Conclusions: In our specific gynecological ultrasound unit, reference cancer centre, the IOTA ADNEX application presents 31% false-positive results, at the expense of the diagnosis of solid tumours, with elevation of Ca125 and vascularised tumours in postmenopausal patients. P07.05Can we improve diagnostic accuracy and ovarian salvage rates for suspected adnexal torsion? A two-year retrospective observational study