ABSTRACT
Purpose
To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses.
Materials and methods
Clinical, biochemical and other sonographic features from 227 women diagnosed as having an entirely solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy.
Results
A total of 227 masses were analyzed. Patients’ mean age was 52.9 years (range: 15-84 years). A total of 150 masses were malignant and 77 were benign. In 52 cases carcinomatosis was observed on ultrasound scan and all theses cases were malignant. In the remaining 175 cases, univariate analysis showed statistical differences between benign and malignant tumors all parameters except tumor's volume. After logistic regression analysis tumor contour, acoustic shadowing, amount of color and CA 125 were identified as independent predictors of malignancy. Using a logistic model 94.4% of malignant tumors and 85.7% of benign tumors would be correctly identified.
Conclusion
The presence of carcinomatosis is invariably associated to malignancy. In absence of carcinomatosis, irregular tumor contour, absence of acoustic shadowing, moderate or abundant blood flow and a high CA 125 are associated to malignancy.
How to cite this article
Utrilla-Layna J, Olartecoechea B, Aubá M, Ruiz-Zambrana A, Pineda L, Alcázar JL. Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings, Clinical Complaints and Biochemical Parameters: A Retrospective Study. Donald School J Ultrasound Obstet Gynecol 2013;7(1):80-85.
Adnexal masses difficult to classify as benign or malignant using subjective assessment of gray-scale and Doppler ultrasound findings: logistic regression models do not help