Clinical Spectrum of Adnexal Mass Lesions in a Tertiary Care Hospital

INTRODUCTION -Adnexal masses can have a wide variety of etiology, and therefore can represent a diagnostic dilemma. Preoperative differential diagnosis of adnexal masses their source of origin, possibility of it being malignant or benign is important so as to determine the optimal mode of management. MATERIAL AND METHODS- The women who presented with complaints of pain abdomen, abdominal distension, decreased appetite, menstrual complaint and were diagnosed with adnexal mass on the basis of clinical examination and other imaging modality were included for this study. Asymptomatic women with a USG report of pelvic mass were also included. . All obstetric patients were excluded. RESULT- A Total of 59 patient were reviewed in this study who were operated in our institute for various adnexal masses. and were categorized on the basis of their malignant potential based on clinical and investigative protocol and to determine the optimal mode of management. Patients were assessed in different age groups. Adnexal masses were studied for cyst size, ascites adnexal masses which were unilocular, complex, solid or heterogenous on ultrasound and Serum CA-125 level. Based on these variables surgery was contemplated and the findings confirmed peroperatively and final diagnosis was made by histopathology. On histopathology, 49 (83 %) masses were benign, 1 (1.7 %) was borderline and 9 (15.3 %) were of malignant pathology. DISCUSSION -Adnexal masses can have a wide variety of etiology, and therefore can represent a diagnostic dilemma. The study helps in estimating the risk of malignancy in a woman with adnexal mass. It was seen that the risk of malignancy in unilocular ovarian cyst is very low. In contrast, complex, solid or heterogeneous ovarian masses are associated with high risk of malignancy CA-125 is the most extensively studied and used tumor marker for predicting the risk of malignancy.