Comparative study of adnexal mass among ultrasonographic findings, perioperative findings and histopathological findings
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260171Keywords:
Adnexal mass, Histopathology, Per-operative findings, UltrasonographyAbstract
Background: Adnexal malignancy is a significant diagnostic challenge in gynaecology and is the third most common cancer of the female genital tract after cervical and endometrial cancer. Accurate preoperative characterization of adnexal masses is crucial for appropriate management, surgical planning and patient referral. Ultrasonography is widely used as a first-line imaging modality because of its accessibility and low cost. This study aimed to assess the diagnostic correlation among ultrasonographic, peroperative and histopathological findings in adnexal masses.
Methods: This prospective cross-sectional observational study was conducted at the Gynaecological Oncology Unit of Dhaka Medical College Hospital, Bangladesh, from July 2021 to June 2022. Seventy female patients aged 14-75 years with sonographically detected adnexal masses who underwent surgery were included. Ultrasonographic morphological features were evaluated preoperatively, intraoperative findings were documented and histopathology was used as a reference standard. Data were analyzed using SPSS version 23.0.
Results: The mean age of the participants was 41.6±19.5 years and 65.7% were premenopausal. Ultrasonography classified 64.3% of masses as benign and 35.7% as malignant, whereas histopathology confirmed 68.6% of masses as benign and 31.4% as malignant. Ultrasonography demonstrated a sensitivity of 90.9%, specificity of 89.6% and overall accuracy of 90.0% compared with histopathology. Per-operative assessment showed comparable diagnostic performance.
Conclusions: Ultrasonography is a reliable, sensitive and specific modality for preoperative evaluation of adnexal masses. Its effective use can facilitate early diagnosis, improve clinical decision-making and potentially enhance survival outcomes through timely and appropriate treatment.
Metrics
References
Dotlić J, Terzić M, Likić I, Atanacković J, Lađević N. Evaluation of adnexal masses: correlation between clinical, ultrasound and histopathological findings. Vojnosanitetski Pregled. 2011;68(10):861-6. DOI: https://doi.org/10.2298/VSP1110861D
Biggs WS, Marks ST. Diagnosis and management of adnexal masses. Am Fam Physi. 2016;93(8):676-81.
Roshed MM, Akhter MD, Hossain SM. A comparative study of nature of adnexal masses by ultrasonography and histopathology. Bangl Medi J Khulna. 2018;51(1-2):7-11.
Rauh-Hain JA, Melamed A, Buskwofie A, Schorge JO. Adnexal mass in the postmenopausal patient. Clin Obstetr Gynecol. 2015;58(1):53-65. DOI: https://doi.org/10.1097/GRF.0000000000000085
Vázquez-Manjarrez SE, Rico-Rodriguez OC, Guzman-Martinez N, Espinoza-Cruz V, Lara-Nuñez D. Imaging and diagnostic approach of the adnexal mass: what the oncologist should know. Chin Clin Oncol. 2020;9(5):69. DOI: https://doi.org/10.21037/cco-20-37
Kaijser J, Bourne T, Valentin L, Sayasneh A, Van Holsbeke C, Vergote I, et al. Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultra Obstetr Gynecol. 2013;41(1):9-20. DOI: https://doi.org/10.1002/uog.12323
Basha MA, Refaat R, Ibrahim SA, Madkour NM, Awad AM, Mohamed EM, et al. Gynecology Imaging Reporting and Data System (GI-RADS): diagnostic performance and inter-reviewer agreement. Europ Radiol. 2019;29(11):5981-90. DOI: https://doi.org/10.1007/s00330-019-06181-0
Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Asilar E, Bergauer T, et al. Measurement of electroweak production of a W boson in association with two jets in proton-proton collisions at s= 13 Te. Europ Phy J C. 2020;80(1):43. DOI: https://doi.org/10.1140/epjc/s10052-019-7585-7
Atri M, Alabousi A, Reinhold C, Akin EA, Benson CB, Bhosale PR, et al. ACR Appropriateness Criteria® clinically suspected adnexal mass, no acute symptoms. J Am Coll Radiol. 2019;16(5):S77-93. DOI: https://doi.org/10.1016/j.jacr.2019.02.011
Torre LA, Trabert B, DeSantis CE, Miller KD, Samimi G, Runowicz CD, et al. Ovarian cancer statistics, 2018. CA: Cancer J Clin. 2018;68(4):284-96. DOI: https://doi.org/10.3322/caac.21456
Cancer Stat Facts: Ovarian Cancer. Available at: https://seer.cancer.gov/statfacts/html/ovary.html. Accessed 01 December, 2025.
Jeong SY, Park BK, Lee YY, Kim TJ. Validation of IOTA-ADNEX model in discriminating characteristics of adnexal masses: a comparison with subjective assessment. J Clin Medi. 2020;9(6):2010. DOI: https://doi.org/10.3390/jcm9062010
Tripathi U, Munda G. Study of correlation of ultrasonography with surgical evaluation of adnexal masses: a prospective study. Int J Reproduct Contracept Obstetr Gynecol. 2018;7(10):4218-23. DOI: https://doi.org/10.18203/2320-1770.ijrcog20184155
Berek JS, Renz M, Friedlander ML, Bast Jr RC. Epithelial ovarian, fallopian tube and peritoneal cancer. Holland‐Frei Cancer Medi. 2016:1-23. DOI: https://doi.org/10.1002/9781119000822.hfcm105.pub2
Roshed MM, Akhter MD, Hossain SM. A comparative study of nature of adnexal masses by ultrasonography and histopathology. Bangl Med J Khulna. 2018;51(1-2):7-11. DOI: https://doi.org/10.3329/bmjk.v51i1-2.40459
Subash KC, Shrestha A, Khadka S, Poudel R. Role of ultrasound in diagnosis and differentiation of benign and malignant ovarian mass: A Hospital based study in Western Nepal. Asian J Medi Sci. 2019;10(5):86-9. DOI: https://doi.org/10.3126/ajms.v10i5.25091
Acharya M, Kumar P, Shrestha BB, Shrestha S, Amatya R, Chhetri PB. Evaluation of adnexal masses-correlation of clinical, sonological and histological findings in adnexal masses. Nepal Medi Coll J. 2020;22(4):199-202. DOI: https://doi.org/10.3126/nmcj.v22i4.34180
Dasgupta S, Mangal S, Naskar K. Evaluation of adnexal masses–correlation of clinical and radiologic features with histopathologic findings: an observational study in a tertiary care center of Eastern India. BBRJ. 2021;5(1):21-6. DOI: https://doi.org/10.4103/bbrj.bbrj_7_21
Sharma A, Lokwani MS, Lokwani S. Correlation between ultrasound features and histopathological findings in adnexal masses-a study in a tertiary care center in central India. 2019.
Yashi SS. Correlation of ultrasound findings with histopathology of pelvic masses in a tertiary care hospital. Int J Health Sci Res. 2019;9(1):46-52.
Abbasi RM, Rizwan N, Shaikh Z. Pattern of pelvic mass among women attending a Gynaecology department of University hospital in Sindh. J Isra Med. 2009;1(2):44-8.
Prabha T, Goyal S, Mishra HK, Aggarwal A. Role of MRI in evaluation of female pelvic masses in comparison to ultrasonography. J Evolut Medi Dent Sci. 2014;3(59):13330-34. DOI: https://doi.org/10.14260/jemds/2014/3775
Aure JC, Høeg K, Kolstad P. Clinical and histologic studies of ovarian carcinoma: long-term follow-up of 990 cases. Obstetr Gynecol. 1971;37(1):1-9. DOI: https://doi.org/10.1097/00006254-197106000-00022
Bennington JL, Ferguson BR, Haber SL. Incidence and relative frequency of benign and malignant ovarian neoplasms. Obstetr Gynecol. 1968;32(5):627-32.
Prakash A, Chinthakindi S, Duraiswami R, Indira V. Histopathological study of ovarian lesions in a tertiary care center in Hyderabad, India: a retrospective five-year study. Int J Adv Med. 2017;4(3):745. DOI: https://doi.org/10.18203/2349-3933.ijam20172265
Fatima R, Sandhya M, Sowmya TS. Study of histomorphological pattern of ovarian neoplastic and non-neoplastic lesions. Int J Res Med Sci. 2017;5(5):2095-8. DOI: https://doi.org/10.18203/2320-6012.ijrms20171849
Patel AS, Patel JM, Shah KJ. Ovarian tumors-Incidence and histopathological spectrum in tertiary care center, Valsad. IAIM. 2018;5(2):84-93.
Myers ER, Bastian LA, Havrilesky LJ, Kulasingam SL, Terplan MS, Cline KE, et al. Management of adnexal mass. Evidence Report/Technology Assessment. 2006;1(130):1-45.