thinking outside the sac... adnexal masses in obstetric ultrasound

Rina Pindoria, London Northwest University Healthcare NHS Trust 


Up to 10% of women will have surgery in their lifetime for the presence of an ovarian mass; in pre-menopausal women most are benign with 1:1000 chance of having a malignant mass. Adnexal masses in pregnancy are not uncommon with a 1-6% malignancy rate. The most common adnexal mass found in pregnancy is a cystadenoma. Mean survival time for a woman with ovarian malignancy is significantly increased when managed within a specialised gynaecological oncology service. Hence early diagnosis and referral is important. Estimating the risk of malignancy is essential and there are several models which can be adopted to do so with ultrasound features of an adnexal mass. The ‘simple rules’ from the international ovarian tumour analysis group can be used as the best approach to classify masses as benign or malignant.

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