Relevance of International Ovarian Tumor Analysis (IOTA) ultrasound rules and ADNEX risk calculator in the investigation of ovarian masses in a semi-rural Indian population

Abstract Objectives To analyze how well untrained examiners – without experience in the use of International Ovarian Tumor Analysis (IOTA) terminology or simple ultrasound-based rules (simple rules) – are able to apply IOTA terminology and simple rules and to assess the level of agreement between non-experts and an expert. Methods This prospective multicenter cohort study enrolled women with ovarian masses. Ultrasound was performed by non-expert examiners and an expert. Ultrasound features were recorded using IOTA nomenclature, and used for classifying the mass by simple rules. Interobserver agreement was evaluated with Fleiss’ kappa and percentage agreement between observers. Results 50 consecutive women were included. We observed 46 discrepancies in the description of ovarian masses when non-experts utilized IOTA terminology. Tumor type was misclassified often (n = 22), resulting in poor interobserver agreement between the non-experts and the expert (kappa = 0.39, 95 %-CI 0.244 – 0.529, percentage of agreement = 52.0 %). Misinterpretation of simple rules by non-experts was observed 57 times, resulting in an erroneous diagnosis in 15 patients (30 %). The agreement for classifying the mass as benign, malignant or inconclusive by simple rules was only moderate between the non-experts and the expert (kappa = 0.50, 95 %-CI 0.300 – 0.704, percentage of agreement = 70.0 %). The level of agreement for all 10 simple rules features varied greatly (kappa index range: -0.08 – 0.74, percentage of agreement 66 – 94 %). Conclusion Although simple rules are useful to distinguish benign from malignant adnexal masses, they are not that simple for untrained examiners. Training with both IOTA terminology and simple rules is necessary before simple rules can be introduced into guidelines and daily clinical practice.

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Surgical tactic in treatment of ovarian masses in adolescents

Pediatrician (St Petersburg) ◽

10.17816/ped6181-86 ◽

2015 ◽

Vol 6 (1) ◽

pp. 81-86

Author(s):

Svetlana Alekseevna Leontyeva ◽

Elena Aleksandrovna Ulrikh ◽

Nadezda Anatolyevna Kokhreidze

Keyword(s):

Abdominal Pain ◽

Surgical Treatment ◽

Ovarian Tumor ◽

Acute Abdominal Pain ◽

Malignant Tumors ◽

Ovarian Torsion ◽

Reproductive Status ◽

Gonadotropin Stimulation ◽

Ovarian Masses ◽

Status Of Women

Ovarian lesions in children are most frequently diagnosed in pubertal period. That could be associated with increased gonadotropin stimulation in this period. Most of the andexal masses in adolescents are benign. Malignant tumors of the ovary account less than 2 % in girls. Every girl with ovarian tumor and acute abdominal pain requires urgent differential diagnostic intervention and/or surgical treatment. The proportion of ovarian torsion is 2-3 % of all cases of abdominal pain in girls. This condition is an emergent gynecological pathology. One of the main aim of surgical treatment in young is to preserve fertility. Different surgery tactics in cases of ovarian masses in adolescents are reviewed in the article. The reproductive status of women underwent treatment for ovarian masses in childhood requires further investigations.

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Ovarian Masses-Applicable IOTA ADNEX Model versus Morphological Findings for Accurate Diagnosis and Treatment

Applied Sciences ◽

10.3390/app112210789 ◽

2021 ◽

Vol 11 (22) ◽

pp. 10789

Author(s):

Tudor Butureanu ◽

Demetra Socolov ◽

Daniela Roxana Matasariu ◽

Alexandra Ursache ◽

Ana-Maria Apetrei ◽

...

Keyword(s):

At Risk ◽

Surgical Treatment ◽

Ovarian Tumor ◽

Malignant Tumors ◽

Benign Tumors ◽

Adnexal Masses ◽

Borderline Tumors ◽

Benign Ovarian Tumor ◽

Significant Difference ◽

Ovarian Masses

A common problem in gynecological practice is the differential diagnosis of the ovarian masses. The clinician must apply the IOTA (International Ovarian Tumor Analysis) ADNEX (Assessment of Different Neoplasia in the Adnexa) model criteria to evaluate the risk of benign, borderline or malignant tumors. The aim of this study was to verify if the IOTA ADNEX model is a practical tool to be used before surgery and if there is a significant difference between IOTA ADNEX criteria and histological findings. A prospective single center study was performed between January 2017 and December 2019 in Obstetrics and Gynecology Hospital “Cuza-Voda”, Iasi, Romania. The study included 230 patients between 17 and 74 years old diagnosed with persistent adnexal masses. We applied the IOTA ADNEX model protocol predicting the risk of benign, borderline or malignant masses. The golden standard remains the histological diagnosis of the surgically removed mass. The patients that had been diagnosed using ultrasonography with persistent adnexal masses between 30 and 291 mm were operated on in our clinic. In our study. the majority of patients had benign ovarian tumor mass, these being 223 (96.96%) patients, from whom, according to IOTA ADNEX protocol, the correspondence was: 91.8–99.7% at risk of benign tumors, 0.3–4.5% at risk of borderline tumors and 0.3–8.2% at risk of malignant masses. Unexpected findings were obtained from the malignant group that included five patients (2.17%) with the following correspondence: 96.1–99% at risk of benign tumors, 0.6–2.4% at risk of borderline tumors and 1–3.9% at risk of malignant masses. After applying the IOTA ADNEX model criteria, the patients with a suspicion of malignant disease were correctly guided towards surgical treatment in an oncological center. In our hospital, surgical treatment was only proposed to those patients with high suspicion of benign masses.

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Ovarian cystadenofibromas: a three cases report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201254 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1728

Author(s):

Hafsa Taheri ◽

Mohammed Reda Kholti ◽

Asma Hmila ◽

Hanane Saadi ◽

Ahmed Mimouni

Keyword(s):

Risk Factors ◽

Ovarian Tumor ◽

Rare Tumor ◽

Pelvic Ultrasound ◽

The Third ◽

Benign Ovarian Tumor ◽

Case Study Report ◽

Clinical Pictures ◽

Ovarian Masses

Ovarian cystadenofibromas is a benign ovarian tumor that typically affects women in their fifth decade. Its risk factors remain unknown. This case study report 3 cases of ovarian cystadenofibromas treated in our department. The patients are aged 21, 28 and 50 years-old. The clinical pictures were polymorphic but the pelvic ultrasound of the case patients showed cystic ovarian masses suspected of malignancy. Two patients underwent laparoscopic ovarian cystectomy, and the third one, aged 50, underwent laparoscopic adnexectomy. The anatomopathological study showed benign ovarian cystadenofibromas. The operating follow ups were simple. It represents a relatively rare tumor whose macroscopic aspect evokes ovarian cancer wrongly leading to an aggressive surgical attitude.

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Age specific clinicopathological profile of ovarian mass

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v6i2.27225 ◽

2019 ◽

Vol 6 (2) ◽

pp. 18-22

Author(s):

Laxmi R.C. Karki ◽

Nishchal Bogati

Keyword(s):

Germ Cell ◽

Ovarian Tumor ◽

Malignant Tumors ◽

Germ Cell Tumors ◽

Clinical Profile ◽

Age Group ◽

Ovarian Mass ◽

Peak Incidence ◽

Neoplastic Lesion ◽

Ovarian Masses

Introductions: Ovarian cancer is seventh leading cause of cancer death among women. Ovarian mass has age specific occurrence and may may help in screening and management plans. This study was conducted to determine the age-wise clinical profile of the ovarian mass. Methods: This review done to analyse the histologically diagnosed ovarian masses in cases operated during three years at Patan Hospital, Patan Academy of Health Sciences, Nepal. Clinical profile of the patients and age-wise distribution of histological types of ovarian mass were analyzed descriptively using Microsoft Excel. Results: Peak incidence of ovarian tumor was in age group of 20-29 years with 93 (36%) cases out of 258 ovarian masses. All eight malignant tumors were in age group of ≥40 years. Neoplastic masses were 188 (72.9%), 95 (50.5%) germ cell tumor. In 70 (27.1%) non-neoplastic lesion, corpus luteal cyst were 24 (34.3%). Conclusions: Peak incidence of ovarian tumor was seen in age group of 20-29 years. Germ cell tumors accounted for half of the neoplastic lesions. All malignant ovarian tumors were in found in age group ≥40 years.

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