An analytical study of 50 women presenting with an adnexal mass
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20164671Keywords:
Adnexal masses, Benign, Malignancy, UltrasonographyAbstract
Background: The aim of this study was to detect and determine the origin of adnexal mass and to narrow down the diagnosis. Also, to determine the reliability of the bimanual pelvic examination in diagnosing adnexal mass and to determine clinical, radiological and histopathological co-relation of adnexal mass. Adnexal mass lesions are fairly common among women (with a prevalence of 0.17% to 5.9% in asymptomatic women and 7.1% to 12% in symptomatic women) of all age group but very common among reproductive age. Differential diagnosis of adnexal mass is difficult and complex. Recognition of the severity of the problem, appropriate and timely evaluation and treatment with good outcome is the goal.
Methods: Prospective, observational study of 50 patients with suspected various adnexal masses were conducted for a period of 1.5yr i.e. from November 2014 to May 2016. All patients underwent pelvic and ultrasonography examination. All patients later underwent surgery. Results were correlated later.
Results: The patient ages ranged from 19 to 58 with a mean age of 31.5. Most common site of origin of adnexal masses is the Ovary (Rt. 38% and Lt. 34%) Most common adnexal masses on histopathological diagnosis are mucinous cyst adenoma (20%), Benign and mature cystic teratoma (16% and 6%) and serous cyst adenoma (10%). About 92% patients with adnexal mass presents with abdominal pain as a chief complaint.
Conclusions: Although bimanual palpation of the adnexal masses may not allow a very specific diagnosis, clinically useful information can usually be obtained and hence it is particularly useful as a first step in assessment of adnexal masses and as an adjunct to morphological assessment of ovarian lesions. Ultrasonography is an important noninvasive investigation and is helpful in diagnosing most of these cases, but the histopathological examination of specimen obtained from laparotomy of adnexal mass is the gold standard for confirming the diagnosis.
References
Padilla LA, Radosevich DM, Milad MP. Accuracy of the pelvic examination in detecting adnexal masses. Obstet Gynecol. 2000;96:593-8.
Juretzka MM. Adnexal Tumors, Assistant Professor of Gynecologic Oncology, Stanford University Hospital and Clinics Coauthor(s): Nelson Teng, MD, PhD, Associate Professor, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Stanford School of Medicine Contributor Information and Disclosures Updated: Oct 16, 2008.
Finkler NJ, Benacerraf B, Lavin P, Wojciechowski C, Knapp RC. Comparison of serum CA 125, clinical impression, and ultrasound in the preoperative evaluation of ovarian masses. Obstet Gynecol. 1988;72:659-64.
Borgfeldt C, Andolf E. Transvaginal sonographic ovarian findings in a random sample of women 25- 40 years old. Ultrasound Obstet Gynecol. 1999;13:345.
Sassone AM, Timor-Tritch IE, Artner A et al. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol. 1991;78:70-6.
Khan S. A Comparison of Pelvic Examination, Pelvic Ultrasound and Operative Findings in Ovarian Masses. APMC. 2008;2(2):121-5.
LeBlond R, DeGowin R, Brown D. The female genitalia and reproductive system: physical exam of the female genitalia and reproductive system. In: DeGowin’s Diagnostic Examination. New York: McGraw-Hill. 2004:623-632.
Russell DJ. The female pelvic mass: Diagnosis and management. Med Clin North Am. 1995;79:1481-93.
Roman LD, Muderspach LI, Stein SM, Laifer-Narin S, Groshen S, Morrow PC. Pelvic examination, tumor marker level, and grayscale and Doppler sonography in the prediction of pelvic cancer. Obstet Gynecol. 1997;89:493-500.
Andolf E, Svalenius E, Astedt B. Ultrasonography for early detection of ovarian carcinoma. Br J Obstet Gynaecol. 1986;93:1286-9.
Ljubic A, Bozanovic T. Sonographic Evaluation of Benign Pelvic Masses. Donald School Journal of Ultrasound in Obstetrics and Gynecology. 2009;3(2):58-68.
Anuradha K, Shweta G, Shukla RC, Mohan K. Evaluation of sassone sonographic scoring system in various adnexal masses. Ultrasound International. 2001;72:148-52.
Anderson JR, Genedry R. Anatomy and Embryology. In: Berek JS ed. Novak’s Gynecology 13th ed. William and Wilkins, Philadelphia. 2002. p.69-122.
Salem S, Wilson SR. Gynecologic ultsrasound. In: Rumack CM, Wison SR, Charboneau JW. Eds. Diagnostic Ultrasound, 3rd ed. St. Louis: Mosby. 2005. p.527-587.
Levi CS, Holt SC, Lyons EA, Lindsay DJ, Dashefsky SM. Normal anatomy of the female pelvis and Transvaginal sonography. In: Peter W. Callen, MD. Ultrasonography in Obstetrics and Gynecology. 5th ed. Philadelphia: WB Saunders. 2008. p.887-918.
Marcus J, Malky D, Mostafa A. Ovarian sonography In: Callen PW. Ultrasonography in Obstetrics and Gynecology.4th ed. Philadelphia: WB Saunders. 2000. p. 857-96.
