The use of RMI in triaging benign pelvic masses from malignant lesions and facilitating their management

Abstract

Background: The most prevalent type of pelvic masses presenting to Gynec OPD are ovarian masses, which include cysts and tumors. Ovarian cancer is more common in older women, with highest incidence in seventies. Ultrasonography and surgically obtained tissue for diagnosis helps in optimising final plan. Good ethical practices suggest involvement of Gynec Oncosurgeon whenever necessary, after a correct preoperative diagnosis of pelvic masses is made. The basic diagnostic work-up of patients with a pelvic mass consists of a gynaecological examination, ultrasound and the analysis of serum tumour markers, especially CA 125. The objective of this study is to triage the patients and ensure optimum therapeutic approach for commonly encountered gynecological pelvic masses and to provide protocol-based treatment

Methods: Ours was a multicentric cross-sectional study in Navi Mumbai on “Patients presenting with abdominal masses” a combined, retrospective as well as prospective during the period of 6 months. 1st January 2023- 30^th June 2023.

Results: The study group comprising of 140 patients in all, from 3 centres, were followed up from diagnosis till treatment comprising of namely: Gynec OPD at General hospital (10), a private MRI centre (30) and those admitted/attending Gynec OPD in Oncology hospital (100) with sonography findings of a pelvic mass greater than 6 cm size. Authors evaluated them on the basis of age, symptoms, and examination and tumor markers and managed as per RMI score to set a protocol.

Conclusions: With the help of ultrasonography findings and Ca125, the risk of malignancy index was calculated and helped us differentiate benign masses from cytology proven malignancy.