Adnexal mass

Chapter 3 ADNEXAL MASS



Kathleen Dor


The key element in the evaluation of an adnexal mass is whether the mass is malignant or benign. Not only can an adnexal mass represent ovarian cancer but it can also be metastatic disease from the breast or gastrointestinal tract or other gynecological neoplasms. Of all ovarian masses, 45% in postmenopausal women are cancer, in comparison with 13% in premenopausal women


Most cases of ovarian cancer are diagnosed at an advanced stage, at which point the overall 5-year survival rate is 30% to 55%. However, in women in whom stage 1 ovarian cancer is diagnosed, the 5-year survival rate is greater than 90%. Risk factors for the development of ovarian cancer include postmenopausal status, a family history of breast or ovarian cancer, nulliparity, infertility, and endometriosis. Other than prophylactic oophorectomy, the only method of decreasing the risk of ovarian cancer is taking combined oral contraceptives.



Causes of an Adnexal Mass



Gynecologic Causes



Benign


• Ectopic pregnancy

• Endometrioma

• Functional cyst

• Hydrosalpinx

• Leiomyomata

• Mature teratoma

• Mucinous cystadenoma

• Polycystic ovarian syndrome

• Serous cystadenoma

• Tubo-ovarian abscess

Malignant


• Epithelial cell ovarian carcinoma

• Fallopian tube carcinoma

• Germ cell tumor

• Gonadal stromal tumor

• Malignant mesodermal sarcoma

• Metastatic breast cancer

• Metastatic uterine cancer

• Ovarian lymphoma

Nongynecologic Causes



Benign


• Appendiceal abscess or mucocele

• Bladder distension

• Bladder diverticulum

• Diverticular abscess

• Hematoma

• Hernia

• Nerve sheath tumors

• Paratubal cyst

• Pelvic kidney

• Ureteral diverticulum

Malignant


• Gastrointestinal cancers

• Retroperitoneal sarcomas


Key Historical Features




✓ General features

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Jun 4, 2016 | Posted by in GYNECOLOGY | Comments Off on Adnexal mass

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