PREVALENCE OF ADNEXAL MASSES IN CHILD, ADOLESCENT AND REPRODUCTIVE AGE FEMALES IN EL-SHATBI GYNEONCOLOGY SPECIALIZED CENTER

Background: An adnexal mass may be found in females of all ages with significantly variable prevalence, but more common among women of reproductive age. Adnexal masses pose a special dilemma to the attending gynaecologist because the diagnosis is often difficult and differential diagnosis is vast. Clinical examination is the first step in evaluation of patients with adnexal mass. Pelvic masses which are undetected or overlooked on physical examination can be identified by Ultrasonography. The aims and objectives of the study were to: to find out different types of adnexal pathology clinically, correlation of clinical finding with histopathology, correlation of ultrasonography finding with histopathology.Methods: The present study was carried in the Department of Obstetrics and Gynecology, Assam medical college and hospital, Dibrugarh from 1st July 2017 to 30th June 2018. This study was a hospital based observational study which included 145 patients of adnexal mass attending the GOPD who required admission and operative intervention. All cases underwent an abdominal ultrasound examination with color Doppler. Transvaginal sonography was done wherever feasible. Following surgery, specimens were sent for histopathological examination and the reports were correlated with pre-operative clinical and ultrasonography findings.Results: The most common site of origin of adnexal mass was ovary (92.41%) followed by fallopian tube (6.20%) and broad ligament (1.39%). Majority (79.31%) were non neoplastic or benign adnexal masses. All cases of adnexal malignancy were of ovarian origin. The sensitivity and specificity of clinical examination for diagnosis and discriminating benign and malignant ovarian neoplasms were 70% and 86.6% and that of ultrasonography was 86.67% and 96.65% respectively.Conclusions: Adnexal mass in reproductive age group were mostly non neoplastic and benign, whereas malignancy was mostly seen in peri and post-menopausal age group. Ultrasonography is a useful adjunct to clinical examination for diagnosis and proper management of patients with adnexal mass in low resource setup.

Download Full-text

Acute abdomen with adnexal masses in the reproductive age group: diagnosis and management

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202308 ◽

2020 ◽

Vol 9 (6) ◽

pp. 2337

Author(s):

Anuradha D. Murki ◽

Vasundhara Kamineni ◽

Sowmya R. Velagapudi ◽

Ashok K. Deshpande

Keyword(s):

Ectopic Pregnancy ◽

Acute Abdomen ◽

Adnexal Mass ◽

Abdominal Distension ◽

Reproductive Age ◽

Age Group ◽

Adnexal Masses ◽

Benign Ovarian Tumours ◽

The Common ◽

Reproductive Age Group

Background: Women with adnexal masses can present with acute symptoms such as abdominal pain, nausea and vomiting. As there is insufficient evidence on the frequency, presentation and management of adnexal masses we conducted this study to evaluate the clinical profile, surgical findings and histopathology of adnexal masses in women presenting with acute abdomen and needing surgical intervention.Methods: In this prospective observational study, history, examination, investigations and ultrasound of abdomen and pelvis were evaluated in women presenting with acute abdomen with adnexal mass and needing surgical intervention. Diagnosis was confirmed from the operative findings and histopathology. Etiology and its correlation with clinical symptoms and signs and radiological diagnosis formed the primary objective of the study.Results: Of the 79 patients enrolled in the study, the mean age was 30.82±6.69 years. Younger women were likely to have ectopic pregnancy while older women (>35 years) other tubal pathologies. Pain abdomen (n=70) and nausea (n=53), bleeding per vagina(n=33), menstrual irregularities (n=18), fever (n=10) abdominal distension (n=10) and dysuria (4) were the common symptoms. Etiology of the adnexal mass was ectopic pregnancy (57%), ovarian mass (34%), tubal mass (7.5%), tube and ovary (2.5%) in 46, 25, 6 and 2 patients respectively. 61% (n=48) of the women underwent laparoscopic management. Women with ruptured ectopic pregnancy were more likely to have abdominal distension, pallor, hypotension, cervical motion tenderness and need for blood transfusions.Conclusions: In women from reproductive age group with adnexal mass and needing surgery, ectopic pregnancies and benign ovarian tumours were the common etiologies. Urine pregnancy test and ultrasound are useful tests to differentiate ectopic from ovarian and tubal pathology.

Download Full-text

Adnexal Masses in Premenopausal Reproductive Age Women

Current Women s Health Reviews ◽

10.2174/1573404813666171016154803 ◽

2018 ◽

Vol 15 (1) ◽

pp. 32-40

Author(s):

Henny Liwan ◽

Steve Hong

Keyword(s):

Tumor Markers ◽

Premenopausal Women ◽

Reproductive Age ◽

First Line ◽

Diagnostic Dilemma ◽

Adnexal Masses ◽

Reproductive Age Women ◽

Imaging Characteristics ◽

Line Imaging ◽

Reproductive Age Group

Background: Adnexal masses in premenopausal women are common reason for referral to OB-GYN. The etiologies vary from non-gynecologic to gynecologic. Once the mass is determined to be gynecologic in its origin, the gynecologist needs to predict if the mass is more likely to be benign or malignant which could lead to a diagnostic dilemma. Objective: This article reviews different histologic type of ovarian tumors, its epidemiology, clinical presentation, imaging appearance and ovarian tumor markers. Familiarity with these patterns will help the clinician narrow the differential diagnosis thus facilitating further management. Results: The incidence of malignancy increases with age. Vast majority of adnexal masses that are ovarian in etiology, 90.5% are benign. The first line imaging is usually a pelvic ultrasound. There are imaging characteristics that could assist in categorizing a mass as more likely to be benign or suspicious for malignancy. Furthermore, there are tumor markers that are approved by FDA to be used as tools to evaluate adnexal masses. Conclusion: Adnexal masses in the reproductive age group demonstrate the greatest histologic variance that is mostly benign. Clinical judgement is important to predict if a mass is likely to be benign or malignant based on risk factors, imaging appearances, and tumor markers. If suspicion of malignancy is high, referral to a gynecologic oncologist is warranted as this may improve patient’s survival.

Download Full-text

ROLE OF ULTRASONOGRAPHY & COLOUR DOPPLER IMAGING IN EVALUATION OF ADNEXAL MASSES

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.891 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Kunal G Solanki ◽

Nikunj Vikram Choudhary

Keyword(s):

Predictive Value ◽

Adnexal Mass ◽

High Sensitivity ◽

Clinical History ◽

Reproductive Age ◽

Doppler Imaging ◽

Transvaginal Sonography ◽

Colour Doppler ◽

Adnexal Masses

Background: Adnexal mass lesions are very common among 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. Ultrasound is the primary modality used for detection and characterization of adnexal masses. The purpose of this study is to evaluate the diagnostic accuracy of ultrasonography in patients suspected with adnexal masses. Objectives: Understanding the characterization of adnexal masses on ultrasonography and colour doppler,and to corelate the usg findings with histopathology where ever possible,to derive simple and clinically useful usg based IOTA rules for discriminating between benign and malignant mass. Methods: The study was conducted on 100 patients with suspected various adnexal masses in a period of 1 year from 2018-2019. Patients are selected based on Clinical history & Adnexal masses detected on pelvic ultrasound. Results of ultrasound were correlated with available histopathological findings. Results: On histopathology, out of total 50 cases studied 14(28%) were malignant and 36 (72%) were benign. Out of 45 cases where IOTA simple rules were applicable, 16(35.5%) were malignant and 29(64.4%) were benign. Conclusion: On comparing the findings of ultrasonogram versus histopathology, it was found that ultrasound had a high sensitivity of 91.66%, 84.84% specificity, 68.7% positive predictive value, 96.55% negative predictive value and 88.8% accuracy of detecting adnexal masses. Keywords: TAS – Transabdominal sonography, TVS – Transvaginal Sonography, Adnexal Masses.

Download Full-text

THE FEATURES OF PRETERM PERIOD AND DELIVERY IN PPATIENTS WITH BENIGN OVARIAN NEOPLASMS

Surgical Practice ◽

10.38181/2223-2427-2020-1-64-71 ◽

2020 ◽

pp. 64-71

Author(s):

A. A. Kalashnik ◽

L. N. Shcherbakova ◽

M. V. Alexeenkova ◽

O. B. Panina

Keyword(s):

General Population ◽

Pregnant Women ◽

Ovarian Neoplasms ◽

Reproductive Age ◽

Medical Society ◽

Ovarian Cysts ◽

Control Group ◽

Adnexal Masses ◽

Significant Difference ◽

Ovarian Teratomas

Abstract: Nowadays medical society is facing increasing numbers of adnexal masses in women of reproductive age, and especially challenging for the diagnostic workup and management are such cases during the pregnancy. Our study has a primary focus on the specific features of the pregnancy and delivery in patients with benign ovarian neoplasms.Materials and methods: This is a retrospective study that included 88 pregnant patients with benign ovarian neoplasms that delivered in our facility during the period from 2014 to 2016. The patients were divided into two groups, the 1st group included 45 pregnant women with endometrioid ovarian cysts, the 2nd group consisted of 43 pregnant women with cystadenomas and ovarian teratomas. As a control group, we used cumulative statistical data from our facility and several related organizations, representing the general population.Results: It was observed, that the odds ratio of the threatened miscarriage and the threat of preterm delivery was significantly higher in patients with endometrioid ovarian cysts compared to the general population. However, the frequency of complications of the preterm period and delivery in patients with cystadenomas and ovarian teratomas showed no significant difference, compared to populational data. There were no significant differences in complications between patients with endometrioid ovarian cysts and cystadenomas / ovarian teratomas.Conclusion: Our research provides additional data on pregnancies with adnexal masses, which can help in the prevention of complications and choosing the modality of treatment in pregnant patients.

Download Full-text

Adnexal masses in children, adolescents and women of reproductive age in the Netherlands: A nationwide population-based cohort study

Gynecologic Oncology ◽

10.1016/j.ygyno.2016.07.096 ◽

2016 ◽

Vol 143 (1) ◽

pp. 93-97 ◽

Cited By ~ 17

Author(s):

Ayke J. Hermans ◽

Kirsten B. Kluivers ◽

Laura M. Janssen ◽

Albert G. Siebers ◽

Marc H.W.A. Wijnen ◽

...

Keyword(s):

Cohort Study ◽

The Netherlands ◽

Population Based ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Adnexal Masses

Download Full-text

ENDOMETRIOSIS : ENIGMATICAL DIAGNOSIS

10.36106/gjra/7202792 ◽

2020 ◽

pp. 1-3

Author(s):

Sandeep Pophale ◽

Shreya Chinchoriya

Keyword(s):

Gold Standard ◽

Histopathological Examination ◽

Clinical Signs ◽

Reproductive Age ◽

Age Group ◽

Women Of Reproductive Age ◽

Adnexal Masses ◽

Common Presentation ◽

The Common ◽

Reproductive Age Group

Background: The prevalence of endometriosis is seen to be from 10% to 20% in the reproductive age group whereas that of endometriosis is 30% to 70% among women presenting with infertility. In our study the incidence of endometriosis appears to be 6.31%. The objective is study the common presentation in cases of endometriosis and their diagnostic accuracy with the help of radiological modalities . laparoscopy and histopathology remains the gold standard modality to diagnose endometriosis. Methods: A total of 200 patients with adnexal masses in the women of reproductive age group were studied. Endometriosis was identified by laparoscopy in 12 cases and confirmed by histopathological examination. Results: Out of the above 200 patients, 6.31% (12 cases) were diagnosed as cases of endometriosis. Out of which, 25% patients had moderate to severe endometriosis. The ultrasound turned out to be an important method in diagnosing the cases of endometriosis Conclusions: The symptoms and clinical signs should raise the suspicion of pelvic endometriosis.ultrasound plays an important role in diagnosing the cases of endometriosis

Download Full-text

An analytical study of 50 women presenting with an adnexal mass

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164671 ◽

2016 ◽

Vol 6 (1) ◽

pp. 262 ◽

Cited By ~ 1

Author(s):

Anand Dipak Bhagde ◽

Shashwat Kamal Jani ◽

Megha Snehal Patel ◽

Sushma Rakesh Shah

Keyword(s):

Adnexal Mass ◽

Histopathological Examination ◽

Cystic Teratoma ◽

Reproductive Age ◽

Histopathological Diagnosis ◽

Adnexal Masses ◽

Cyst Adenoma ◽

Mucinous Cyst ◽

Serous Cyst Adenoma ◽

Mass Lesions

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.

Download Full-text

Role of laparoscopy in the diagnosis and management of benign adnexal masses

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20185391 ◽

2018 ◽

Vol 7 (1) ◽

pp. 255

Author(s):

Ajay Wakhloo ◽

Suksham Sharma ◽

Gagan Singh

Keyword(s):

Pap Smear ◽

Preoperative Evaluation ◽

Age Groups ◽

Laparoscopic Approach ◽

Reproductive Age ◽

Adnexal Masses ◽

Diagnosis And Management ◽

Uterine Ligaments ◽

Reproductive Age Group

Background: Adnexal masses are frequent findings in women of all age groups. It consists of the ovaries, fallopian tubes and uterine ligaments. Women can present with various gynaecological complaints and adnexal masses could be detected while examining and investigating for these complaints. The aim was to study the role of laparoscopy in diagnosis and management of benign adnexal masses.Methods: The study was conducted on 48 women of reproductive age group. Per speculum examination was done and PAP smear was taken before bimanual examination was done. A complete per vaginum examination was done and the adnexal mass was assessed for its size, side, consistency, laterality and tenderness. Laparoscopy was done to confirm preoperative diagnosis and appropriate procedure done depending on diagnosis.Results: Pain in the lower abdomen was the commonest chief complaint seen in 87.5% cases. 41.67% cases were suspected to have endometriosis while on laparoscopy it was seen in 47.92%, 33.33% were suspected to have ovarian cyst which decreased to 25% on laparoscopy, ectopic pregnancy in 16.67% cases both pre-operative and on laparoscopic examination and tubo-ovarian mass in 8.33% cases pre-operatively and 2.08% on laparoscopy.Conclusions: This study has shown that if proper preoperative evaluation was done, author can select the appropriate patients for laparoscopic approach.

Download Full-text