Materiały źródłowe

• #1 Adnexal Mass: Tumor, Cyst, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22015-adnexal-mass-tumors

  An adnexal mass forms near your ovaries, fallopian tubes or surrounding connective tissues. Most adnexal tumors are benign (noncancerous), but they can be malignant (cancerous). Many adnexal masses go away on their own, but some require treatment, which may include surgery. […] You can develop an adnexal mass for many reasons. […] Many gynecologic and nongynecologic conditions can cause adnexal masses. Most commonly, the tumors originate in your reproductive organs (gynecologic). But they can also originate in your urinary or digestive systems (nongynecologic). […] Gynecological causes are the most common type of adnexal mass. A gynecological cause is anything that relates to your reproductive system. There can be many reasons (maybe even hundreds of reasons) you develop an adnexal mass.

• #1 Adnexal tumors and masses – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adnexal-tumors/symptoms-causes/syc-20355053

  Adnexal tumors and masses are growths of cells that form on the organs and connective tissue around the uterus. Adnexal tumors and masses most often aren’t cancer, but they can be cancer. […] There are many possible causes of adnexal tumors and masses. Causes that are more common include: […] Cysts can happen within the ovaries and fallopian tubes as well as in the connective tissue around them. […] Endometriosis happens when tissue that is similar to the inner lining of the uterus grows outside the uterus. […] An ectopic pregnancy happens when a fertilized egg implants and grows outside the main cavity of the uterus, most often in a fallopian tube. […] Examples of other health conditions that can lead to adnexal tumors and masses include: […] Most adnexal tumors and masses are not cancer. But some may be cancer that affects the ovaries, fallopian tubes or the tissue around them.

• #1 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  The cyclic ovarian function of a reproductive-age women continually produces follicular growth and resorption. […] Endometriosis is a condition in which implants of normal-appearing endometrial glands and stroma are found outside their normal location in the uterine cavity. […] The most common benign cystic neoplasms of the ovary are serous and mucinous cystadenomas and cystic teratomas (dermoids). […] Malignant degeneration occurs in benign cystic teratomas in 1% to 3% of these tumors, and it is usually of a squamous type. […] The CA-125 to carcinoembryonic antigen (CEA) ratio is now being considered helpful in deciphering the site of neoplastic origin. […] The OVA1 test is a biomarker panel that measures five proteins to better classify adnexal masses to assist physicians with making referral to gynecologic cancer specialists. […] The presence and severity of symptoms are other important considerations. […] Masses that raise a suspicion for malignancy require surgical intervention.

• #1 Adnexal mass: Symptoms, treatment, and diagnosis

  https://www.medicalnewstoday.com/articles/327525

  Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological. […] The cause of adnexal masses could be gynecological or nongynecological. […] Some of the causes of adnexal masses include: Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus. Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown. Leiomyoma: A benign gynecological tumor, also known as a fibroid. Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs. Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection. Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease. Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

• #1 Adnexal Torsion – Gynecology and Obstetrics – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/gynecology-and-obstetrics/miscellaneous-gynecologic-disorders/adnexal-torsion

  Adnexal torsion is one of the most common gynecologic emergencies, occurring most often during reproductive years. It usually occurs when the ovary is enlarged because of a mass or other problem. […] Benign tumors are more likely to cause torsion than malignant ones. […] Adnexal torsion of the ovary and/or fallopian tube is a common gynecologic emergency; it usually occurs when the ovary is enlarged because of a mass or other problem. […] If adnexal torsion is diagnosed, immediately attempt to salvage the ovary and fallopian tube by untwisting them via laparoscopy or laparotomy; if nonviable or necrotic tissue or an ovarian cyst or mass is present, surgical removal (salpingo-oophorectomy, cystectomy) is required.

• #1 Adnexal tumors and masses – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/adnexal-tumors-and-masses/

  Adnexal tumors and masses are growths of cells that form on the organs and connective tissue around the uterus. Adnexal tumors and masses most often aren’t cancer, but they can be cancer. […] There are many possible causes of adnexal tumors and masses. Causes that are more common include: […] Cysts can happen within the ovaries and fallopian tubes as well as in the connective tissue around them. […] Endometriosis happens when tissue that is similar to the inner lining of the uterus grows outside the uterus. […] An ectopic pregnancy happens when a fertilized egg implants and grows outside the main cavity of the uterus, most often in a fallopian tube. […] Most adnexal tumors and masses are not cancer. But some may be cancer that affects the ovaries, fallopian tubes or the tissue around them.

• #1 Diagnosis and Management of Adnexal Masses | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0415/p676.html

  Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. […] The etiology of adnexal masses ranges from physiologically normal luteal cysts to ovarian cancer. […] Ovarian malignancy is diagnosed approximately 22,000 times per year in the United States, making it the second most common gynecologic cancer; in 2010, nearly 14,000 women died of ovarian cancer. […] Other risk factors for ovarian cancer include nulliparity, obesity, delayed child-bearing, use of fertility-enhancing medications, and unopposed estrogen exposure. […] The differential diagnosis for adnexal masses is broad. […] Malignant causes include endothelial carcinoma, sarcoma, and borderline tumors. […] Because adnexal masses can have gastrointestinal, urinary, or metastatic sources, ovarian origin should not be assumed.

• #1 Adnexal Tumors: What Causes Them, and How They Are Treated

  https://www.webmd.com/women/what-are-adnexal-tumors

  Adnexal tumors are growths near the uterus. They’re also known as adnexal masses. Many conditions can cause an adnexal tumor and they can happen at any age. […] Benign ovarian tumors usually grow slowly and rarely become malignant, or cancerous. […] Malignant ovarian tumors are also classified based on where they originally started to grow. […] Malignant nonovarian. These are cancerous masses that form outside of the ovaries. […] There are also conditions that can cause adnexal masses that don’t have anything to do with your ovaries, fallopian tubes, uterus, or connective tissues.

• #1 The etiology of adnexal masses in women with a history of non-gynaecological malignancy: recurrence, second, primary or none?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9743350/

  The occurrence of adnexal masses in patients with a history of non-gynaecological malignancy (NGM) raises concerns for malignancy, either primary or metastasis. […] The most common NGM origins were gastrointestinal (gastric and colorectal) tract and breast. […] Among the patients with history of gastrointestinal cancers, the percentage of ovarian metastasis was 81%. […] Primary ovarian malignancy was most frequently (64%) observed among the patients with history of breast cancers. […] For patients with a history of gastrointestinal cancer, recurrence of the cancer in the form of ovarian metastasis was more likely, rather than a second primary cancer. […] The risk of primary ovarian cancer (POC) was remarkable in those with history of a breast cancer. […] Ovarian metastasis is usually associated with an advanced, incurable disease and needs only palliative systemic therapy.

• #1 The etiology of adnexal masses in women with a history of non-gynaecological malignancy: recurrence, second, primary or none?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9743350/

  In contrast, primary ovarian cancer (POC) is a potentially curable disease and the standard treatment is surgery followed by systemic chemotherapy. […] Metastasis comprises 5-20% of all ovarian neoplasms and the most common non-gynecological source is gastrointestinal tract cancer (57%), followed by breast cancer (30%). […] Although the ovaries are frequently the site of metastasis from NGM, women with a history of NGM may also be at increased risk of developing a POC. […] Despite the low overall rate of POCs, in those with a history of breast cancer presenting with a suspicious adnexal mass this was as high as 64%. […] Serum tumor markers may aid as part of the evaluation of these patients. […] These NGM-related markers, including CEA, CA19-9 and CA15-3, might be useful in identifying the etiology of adnexal mass, but they might also be elevated at a POC.

• #1 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  Detection of pelvic abnormalities is more frequent in women of reproductive age because these patients have serial examinations as part of periodic screening for cancer. […] The differentiation between benign and malignant ovarian enlargements is often the exclusive decision of the pathologist, but a short discussion of these lesions is pertinent even in a textbook of oncology. […] Although it is not known whether malignant ovarian tumors arise de novo or develop from benign tumors, there is strong inferential evidence that at least some benign tumors will become malignant. […] The most common entity of the GI tract that initially appears to be an adnexal mass is fecal material in the sigmoid colon or cecum, which may on initial pelvic examination be palpated as a soft, mobile, tubular mass.

• #1 Characterisation of Adnexal Masses | SpringerLink

  https://link.springer.com/10.1007/978-3-642-13327-5_136

  The adnexa adjoin the uterus and contain the ovaries, fallopian tubes, associated vessels, support ligaments and connective tissue. […] Pathology in the adnexa may also arise from the uterus, bowel, bladder, retroperitoneum, nerves or peritoneal metastatic deposits from another site particularly breast, stomach or colon. […] Processes that lead to development of adnexal masses include congenital masses, functional cysts, haemorrhagic lesions, neoplastic masses or inflammatory diseases. […] As treatment options will vary considerably depending on the etiology of the mass, accurate diagnosis is of paramount importance.

• #1 Adnexal Tumors: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/258044-overview

  The normal functioning ovary produces a follicular cyst 6-7 times each year. In most cases, these functional cysts are self-limiting and resolve within the duration of a normal menstrual cycle. In rare situations, a cyst persists longer or becomes enlarged. At this point, it represents a pathological adnexal mass. […] Since ovaries produce physiologic cysts in menstruating women, the likelihood of a benign process is higher in women of reproductive age. In contrast, the presence of an adnexal mass in prepubertal girls and postmenopausal women heightens the risk of a malignant neoplastic etiology. […] The pathophysiology is not well understood for most adnexal masses; however, some theories have been proposed. Functional cysts may be the result of variation in normal follicle formation. Mature cystic teratoma may be the result of abnormal germ cell proliferation. Endometriomas are thought to result from retrograde menstruation or coelomic metaplasia. The exact cause of epithelial neoplasms is unknown, but recent studies have suggested a complex series of molecular genetic changes is involved.

• #1 Adnexal tumors and masses – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/adnexal-tumors-and-masses/

  People who have gone through menopause are more likely to have an adnexal tumor or mass that is cancer than are people who haven’t gone through menopause. […] People who have used infertility medicines with hormones are at a higher risk of a cancerous adnexal tumor or mass. […] People with family members who have had breast cancer, ovarian cancer or fallopian tube cancer are at higher risk of developing a cancerous adnexal tumor or mass. […] DNA changes that raise the risk of cancer can be passed from parents to children. […] Cigarette smoking raises the risk of developing an adnexal tumor or mass that is cancer.

• #1 Adnexal mass: Symptoms, treatment, and diagnosis

  https://www.medicalnewstoday.com/articles/327525

  Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger. […] Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include: inherited genetic changes, hereditary nonpolyposis colorectal cancer, endometriosis, postmenopausal hormonal therapy, obesity, tall height.

• #1 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Age is a significant independent risk factor for ovarian malignancy in the general population, with the incidence increasing sharply after the onset of menopause. […] Nulliparity, early menarche, late menopause, caucasian race, primary infertility, and endometriosis are contributing factors for a higher risk for ovarian cancer. […] The most critical personal risk factor for ovarian cancer is a strong personal or family history of breast or ovarian cancer, as they may be carriers of deleterious mutations in genes related to these two types of cancer. […] Patients with symptomatic adnexal masses, especially climacteric, have a higher risk of malignancy. […] Ovarian cancer presents nonspecific symptoms within the last 12 months mimicking irritable bowel syndrome, unspecified gastric symptoms, fatigue, and unexplained weight loss.

• #1

  https://continentalhospitals.com/diseases/adnexal-tumors/

  Understanding the risk factors associated with adnexal tumors is crucial in identifying potential preventive measures and implementing effective treatment strategies. […] A family history of adnexal tumors or other related cancers can also play a role in an individual’s susceptibility. Genetic predisposition and inherited mutations may increase the likelihood of developing these tumors. […] Certain lifestyle factors have been identified as potential risk factors for adnexal tumor development. Smoking tobacco products has been linked to an increased risk, as well as exposure to certain chemicals or toxins in occupational settings. […] It is important to note that while these risk factors may increase the likelihood of developing adnexal tumors, they do not guarantee their occurrence.

• #1 Management of the Adnexal Mass | Obgyn Key

  https://obgynkey.com/management-of-the-adnexal-mass-2/

  Uterine adnexae are defined as the areas adjacent to the uterus that are occupied by the fallopian tubes and ovaries. The embryologic origin of the fallopian tubes and ovaries are 2 distinct events in the development of a female embryo. Development of the ovaries begins before the development of the remainder of the genital tract. The origin of the male and female gonads are similar up until the seventh week of gestation, at which time the primitive sex cords begin to break up in the female embryo. The developing ovary eventually has 3 layers: the surface epithelium, primitive germ cells, and sex cord epithelium. These layers give rise to the 3 main types of ovarian tumors: (1) epithelial tumors, which comprise approximately 70% of all ovarian neoplasms; (2) germ cell tumors, which comprise 15% to 20% of ovarian tumors; and (3) sex cordstromal tumors, which account for 5% to 10% of ovarian tumors. The remainder of the masses are a result of metastatic or secondary involvement to the ovary.1

• #1 Adnexal tumor – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/adnexal-tumor/

  Noncancerous ovarian tumors: Abnormal cell growth in the ovaries results in solid masses, occasionally with cystic components. These tumors are typically benign and do not spread to nearby tissues or other parts of the body. […] Ectopic pregnancy: When a fertilized egg implants somewhere other than the uterus, such as the fallopian tube. Ectopic pregnancies cannot be carried to term and can cause internal bleeding and intense pain. If left untreated, they can be life-threatening. […] Broad ligament leiomyoma: A leiomyoma (benign tumor) located next to the ovary and fallopian tube, often mistaken for an adnexal mass. […] Tubo ovarian abscess: Infections that affect the vaginal system can result in inflammation of the ovary, fallopian tube, and, on rare occasions, other organs including the intestine or bladder. […] Hydrosalpinx: A hydrosalpinx is an accumulation of fluid in the fallopian tube. Hydrosalpinx can cause pelvic discomfort or infertility even though it frequently shows no symptoms at all.

• #1 Ovarian Cysts and Masses | Best Gynecological Surgeon Los Angeles

  https://www.draliabadi.com/gynecology/ovarian-conditions/cysts-and-masses/

  What causes ovarian cysts? […] Common causes of ovarian cysts include: […] Functional cysts may be caused by hormonal problems or drugs used to help you ovulate. […] […] Endometriosis tissue can attach to the ovary and form a growth. […] […] An ovarian cyst can develop early in pregnancy to help support the pregnancy until the placenta forms. […] […] Pelvic infections can spread to the fallopian tubes and ovaries and cause cysts to form. […] What are adnexal masses? […] An adnexal mass is a growth that forms near the uterus (in the ovaries, fallopian tubes, or connective tissues). In premenopausal women, adnexal masses include ovarian cysts, ectopic pregnancies, benign or malignant ovarian tumors, endometriomas, polycystic ovaries, and tubo-ovarian abscess, and the risk of malignancy is low. […] […] Adnexal masses can be physiologic or complex. Common causes for adnexal masses are follicular cysts and corpus luteum cysts. Abscesses can form as a complication of pelvic inflammatory disease.

• #1 What Is the Role of Laparoscopy in the Management of Adnexal Masses?

  https://www.icliniq.com/articles/womens-health/role-of-laparoscopy-in-the-management-of-adnexal-masses

  Adnexal masses originate mostly from the female reproductive system. They can also originate from the digestive or urinary systems. Numerous gynecological and nongynaecological factors can cause them. […] Most adnexal masses are caused within the female reproductive system. Some of the most common causes include: […] Ovarian cancers are the most common type of cancer seen in women. The ovarian tumor grows and spreads to other body areas when it is cancerous. […] Non-gynecologic adnexal tumors usually originate from the gastrointestinal or urinary systems. Some of the most common types include adnexal tumors of the appendix and colon. Colon and breast cancers can also spread to the pelvic region resulting in adnexal tumors.

• #1 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Adnexal masses occurred in women of all age groups, and their etiology and frequency vary age accordingly. […] The adnexal mass may come from functional or physiological changes, inflammatory processes, endometriosis, benign and malignant tumor. […] The incidence and mortality due to ovarian cancer have remained stable over the past three decades and represent the leading cause of death from malignant neoplasm of the female genital tract in developed countries. […] The mainstream to management of adnexal masses is excluding malignancies. […] The characterization of malignancy findings on the image (TVUS or MRI) is the key since women with ovarian cancer should preferably be treated in oncological referral centers as soon as possible. […] Estimate the malignancy risk index is essential to assess an adnexal mass.

• #1 Diagnosis and Management of Adnexal Masses | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0415/p676.html

  Common symptoms associated with adnexal masses include irregular vaginal bleeding, bloating, increased abdominal girth, dyspareunia, urinary symptoms, pelvic pain, and abdominal pain. […] Pain, increased abdominal size, bloating, and urinary symptoms may be more indicative of malignant rather than benign causes. […] Risk of ovarian malignancy increases with ovarian mass size greater than 6 cm, bilaterality, septation, and presence of ascites.

• #1 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Transvaginal ultrasonography (TVUS) is the single most effective way of evaluating an ovarian mass. […] Tumor markers can be used alone or in combination with imaging tests and clinical information for the differential diagnosis of adnexal masses. […] The CA125 transmembrane glycoprotein is elevated in 80% of ovarian carcinomas, especially in advanced tumors. […] The effectiveness of using panels of biomarkers combined with clinical and radiologic evaluation for the distinction between benign and malignant adnexal masses has been studied. […] The risk of malignancy index (RMI) algorithm combines the value of CA 125 serum levels, ultrasound, and menopausal status. […] The incidence of adnexal masses in childhood and adolescence is very low, higher in the first year of life due to hormonal phenomena in utero, and rises again close to menarche.

• #1 Evaluation of the Adnexal Mass in an Older Patient

  https://exxcellence.org/pearls-of-exxcellence/list-of-pearls/evaluation-of-the-adnexal-mass-in-an-older-woman/

  Age is the most significant risk factor for ovarian cancer, with a lifetime risk for ovarian cancer of 1 in 70. […] Serum markers such as Cancer Antigen 125 (CA125), Human Epididymis 4 (HE4) and newer Multivariate Index Assays (OVA1, OVA2, ROMA) are added tools to evaluate adnexal masses. CA125 can be elevated in both benign and malignant conditions. CA125 and HE4 together may have improved diagnostic value for differentiating benign and malignant masses. […] If the tumor is 5 cm or there is any evidence of papillary projections or ascites, the patient should be referred to a gynecologic oncologist.

• #1 Female Pelvic Mass in Children – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/symptoms-of-gynecologic-disorders/female-pelvic-mass-in-children

  The etiology, diagnosis, and treatment of a female pelvic mass vary by reproductive phase or status: premenarche, reproductive age, pregnancy, or menopause. […] In prepubertal girls, pelvic masses are uncommon. Ovarian masses may be follicular ovarian cysts or, rarely, benign or malignant tumors. Germ cell tumors, including gonadoblastoma and mature teratomas, are the most common type of ovarian neoplasm in children, and benign epithelial tumors (eg, serous and mucinous cystadenoma) may also occur. Malignant tumors include immature teratoma, germinoma, granulosa cell tumor, and Sertoli-Leydig cell tumor. […] Pelvic inflammatory disease is rare in prepubertal girls but can occur and may be complicated by a tubo-ovarian abscess or hydrosalpinx. […] A pelvic mass in a girl with precocious puberty raises concern for a hormone-producing tumor. […] Some adnexal masses may be safely monitored and may resolve spontaneously (eg, follicular ovarian cysts). […] Surgery is required if a benign or malignant neoplasm is suspected based on imaging or tumor markers, or if adnexal torsion is likely.

• #1 Adnexal Diseases | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-27355-1_15

  Adnexal masses may present as symptomatic lesions or be discovered incidentally during radiological examinations. […] In premenopausal women the majority of these are detected by Ultrasound and are benign lesions such as physiological cysts, endometriomas, mature ovarian teratomas (dermoid cysts), cyst adenomas or lesions of the fibroma lineage. In postmenopausal women adnexal masses are also likely to be benign. […] The rapid expansion in the use of computed tomography (CT) for first-line assessment of the urinary and gastrointestinal tracts, investigation of patients presenting with non-specific symptoms, with an acute abdomen or following trauma has resulted in many adnexal masses being diagnosed but not characterised. […] Of incidentally detected adnexal cysts at CT, the ovarian cancer rate is approximately 0.7%.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Types-of-Adnexal-Tumors.aspx

  Adnexal tumors refer to a large group of conditions of gynecologic and non-gynecologic origin. These masses can be benign or malignant. Various types of adnexal tumors based on the site of their occurrence are discussed below. […] In the case of pregnant women, corpus luteum cyst is the most common etiology of adnexal tumors. In non-pregnant women, functional cysts and leiomyomata cause adnexal tumors. […] Most skin adnexal masses are benign, and surgical removal of the growth offers complete cure. However, some of these masses may be markers for other underlying syndromes such as sebaceous tumors in the case of MuirTorre syndrome and trichilemmomas in the case of Cowden disease. […] Malignant skin adnexal tumors are often rare and locally aggressive, though they can involve nodes and can metastasize. The clinical outcome of such tumors is often very poor. […] Adnexal tumors of the eye are rare compared to other adnexal tumors. However, their diagnostic importance is huge given the functional significance of the eye and periocular structures.

• #1 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Most ovarian carcinomas occur in women over 50 years of age. […] Ovarian cancer, while typically cystic, does not arise from these benign-appearing cysts. […] The minimally invasive surgery (MIS) is a well-established route in propaedeutic and treatment of benign adnexal masses and has been progressively indicated in oncology. […] When a patient with a suspicious or persistent complex adnexal mass requires surgical evaluation, a physician trained to appropriately stage and debulk ovarian cancer, such as a gynecologic oncologist, should perform the operation. […] Frozen sections for the intraoperative diagnosis of a suspicious adnexal mass is recommended in settings in which availability and patient preference allow. […] Referrals to oncology specialists for additional treatment should occur when malignancy is found during laparoscopy or after histology. […] Adnexal masses are anomalies that affect women of all ages, from the earliest childhood to senility.

• #1 Non-Gynecologic Causes of Adnexal/Pelvic Masses

  https://www.eurekaselect.com/article/89588

  Pelvic masses can pose a diagnostic dilemma with a broad differential to include both gynecological and non-gynecologic etiologies. […] The etiology of adnexal masses covers several subspecialties: gynecology, urology, gastroenterology, neurology, and oncology. […] For this reason, it is important for all to be aware of the differential diagnosis for pelvic masses.

• #2 Adnexal tumors and masses – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/adnexal-tumors/symptoms-causes/syc-20355053

  Adnexal tumors and masses are growths of cells that form on the organs and connective tissue around the uterus. Adnexal tumors and masses most often aren’t cancer, but they can be cancer. […] There are many possible causes of adnexal tumors and masses. Causes that are more common include: […] Cysts can happen within the ovaries and fallopian tubes as well as in the connective tissue around them. […] Endometriosis happens when tissue that is similar to the inner lining of the uterus grows outside the uterus. […] An ectopic pregnancy happens when a fertilized egg implants and grows outside the main cavity of the uterus, most often in a fallopian tube. […] Examples of other health conditions that can lead to adnexal tumors and masses include: […] Most adnexal tumors and masses are not cancer. But some may be cancer that affects the ovaries, fallopian tubes or the tissue around them.

• #2 Adnexal Tumors: What Causes Them, and How They Are Treated

  https://www.webmd.com/women/what-are-adnexal-tumors

  Adnexal tumors are growths near the uterus. They’re also known as adnexal masses. Many conditions can cause an adnexal tumor and they can happen at any age. […] Benign ovarian tumors usually grow slowly and rarely become malignant, or cancerous. […] Malignant ovarian tumors are also classified based on where they originally started to grow. […] Malignant nonovarian. These are cancerous masses that form outside of the ovaries. […] There are also conditions that can cause adnexal masses that don’t have anything to do with your ovaries, fallopian tubes, uterus, or connective tissues.

• #2 Diagnosis and Management of Adnexal Masses | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1015/p815.html

  In nonpregnant patients, the most common etiologies are functional cysts and leiomyomata. […] The U.S. Preventive Service Task Force recommends against routine screening for ovarian cancer, including use of transvaginal ultrasonography, CA 125 level, and screening pelvic examination. […] Several tumor markers exist that may be helpful in the evaluation of patients with adnexal masses. CA 125 is an antigenic determinant found in benign and malignant conditions. […] Hereditary ovarian cancer accounts for only a small percentage of overall cancer cases.

• #2 ADNEXAL MASSES & OVARIAN CYSTS – Dr. Charles E. Miller

  https://drcharlesmiller.com/gynecologic/adnexal-masses-ovarian-cysts/

  Most adnexal masses develop in the ovary. […] Some causes of adnexal masses are listed below: […] Functional Cysts During ovulation an egg is matured in a follicle that develops and then ruptures to release the egg. […] Polycystic Ovary This ovary is enlarged due to the development of many small follicles. […] Endometrioma Ovarian cyst that contains tissue from the uterine lining or endometrium; also referred to as a chocolate cyst because the fluid inside is old blood produced from the endometrial tissue in the cyst and looks like chocolate. […] Dermoid (aka Mature Cystic Teratoma) This cyst arises in the ovary and is a benign tumor consisting most commonly of hair, fat and teeth. […] Fibroma This is a solid benign tumor of the ovary that may be associated with fluid in the abdomen and lungs (Meigs Syndrome).

• #2 Adnexal Mass: Symptoms, Treatments, and How It Affects Pregnancy

  https://www.healthline.com/health/adnexal-mass

  An adnexal mass is a growth that occurs in or near the uterus, ovaries, fallopian tubes, and the connecting tissues. Theyre usually benign, but are sometimes cancerous. […] There are many hundreds of causes of adnexal masses. The most common causes are described below. […] Ovarian cancer is one of the most common forms of cancer in women. Abnormal cells in the ovary multiply and form a tumor. This tumor has the capacity to grow and spread to other areas of the body. […] An ectopic pregnancy is when a fertilized egg doesnt make it to the uterus and implants in a fallopian tube instead. Ectopic pregnancies are unable to grow to term. […] About 10 percent of adnexal masses discovered in pregnancy are malignant, according to one 2007 clinical review. Even in these cases, the cancer is usually in its early stages. […] In a very small number of cases, the cause of the adnexal mass will be ovarian cancer.

• #2 Adnexal mass: Symptoms, treatment, and diagnosis

  https://www.medicalnewstoday.com/articles/327525

  Adnexal masses are lumps that occur in the adnexa of the uterus, which includes the uterus, ovaries, and fallopian tubes. They have several possible causes, which can be gynecological or nongynecological. […] The cause of adnexal masses could be gynecological or nongynecological. […] Some of the causes of adnexal masses include: Ectopic pregnancy: A pregnancy where the fertilized egg implants somewhere outside the uterus. Endometrioma: A benign cyst on the ovary that contains thick, old blood that appears brown. Leiomyoma: A benign gynecological tumor, also known as a fibroid. Ovarian cancer: These tumors of the ovary may be ovarian epithelial cancers that begin in the cells on the surface of the ovary or malignant germ cell cancers that begin in the eggs. Pelvic inflammatory disease: Inflammation of the upper genital tract, which includes the uterus, fallopian tubes, and ovaries. It occurs due to an infection. Tubo-ovarian abscess: An infectious adnexal mass that forms because of pelvic inflammatory disease. Ovarian torsion: A gynecological emergency involving a complete or partial rotation of the tissue that supports the ovary, which cuts off blood flow to the ovary.

• #2 Adnexal Mass: Tumor, Cyst, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22015-adnexal-mass-tumors

  Most adnexal tumors are benign (noncancerous). But a small percentage are malignant (cancerous). Your risk for having a malignant adnexal tumor increases after menopause. […] Most adnexal masses arent serious. Only a healthcare provider can determine if a mass is something to worry about. Adnexal masses arent typically cancerous and dont usually long-term or life-threatening complications. […] But some causes of adnexal masses do have serious complications. The causes of tumors that do carry risks of serious complications are: Ectopic pregnancy, Cancer, Any cysts that rupture or leak blood or other fluids, Adnexal torsion (when your ovary or fallopian tubes twist). […] No. You cant prevent adnexal tumors. But with early detection, you can reduce your risk for complications. […] If you have an adnexal mass, your healthcare provider will recommend a treatment plan thats unique to your situation. Oftentimes, adnexal tumors go away on their own without any treatment. […] Most adnexal tumors arent dangerous, and they may even go away on their own over time. In rare instances, the tumor may be cancerous. Only a healthcare provider can determine if the mass is serious or life-threatening (like with an ectopic pregnancy or cancer).

• #2 Diagnosis and Management of Adnexal Masses | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/1015/p815.html

  Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. They may be benign or malignant. […] The differential diagnosis of an adnexal mass includes benign and malignant gynecologic and non-gynecologic etiologies. The goal of evaluation is to differentiate between benign and more serious conditions, such as ovarian cancer. […] Ovarian cancer is the leading cause of death from gynecologic malignancy. It is the fifth leading cause of cancer death in women in the United States, accounting for 15,280 deaths in 2007. The risk of ovarian cancer increases steadily with age, with the greatest risk occurring after menopause. […] Ovarian cancer is rare in premenopausal women. Other etiologies, such as functional cysts, leiomyomata, and ectopic pregnancy, are more common and can cause significant morbidity.

• #2 The etiology of adnexal masses in women with a history of non-gynaecological malignancy: recurrence, second, primary or none?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9743350/

  In contrast, primary ovarian cancer (POC) is a potentially curable disease and the standard treatment is surgery followed by systemic chemotherapy. […] Metastasis comprises 5-20% of all ovarian neoplasms and the most common non-gynecological source is gastrointestinal tract cancer (57%), followed by breast cancer (30%). […] Although the ovaries are frequently the site of metastasis from NGM, women with a history of NGM may also be at increased risk of developing a POC. […] Despite the low overall rate of POCs, in those with a history of breast cancer presenting with a suspicious adnexal mass this was as high as 64%. […] Serum tumor markers may aid as part of the evaluation of these patients. […] These NGM-related markers, including CEA, CA19-9 and CA15-3, might be useful in identifying the etiology of adnexal mass, but they might also be elevated at a POC.

• #2 The etiology of adnexal masses in women with a history of non-gynaecological malignancy: recurrence, second, primary or none? – Journal of the Turkish-German Gynecological Association

  https://www.jtgga.org/articles/the-etiology-of-adnexal-masses-in-women-with-a-history-of-non-gynaecological-malignancy-recurrence-second-primary-or-none/doi/jtgga.galenos.2021.2021-0031

  Although the ovaries are frequently the site of metastasis from NGM, women with a history of NGM may also be at increased risk of developing a POC. […] In the present study, colorectal cancer was the most common NGM resulting in metastasis to the ovaries and the rate of POC was extremely low (13.6%). […] Despite the low overall rate of POCs, in those with a history of breast cancer presenting with a suspicious adnexal mass this was as high as 64%. […] Serum tumor markers may aid as part of the evaluation of these patients. We found CA125 useful in identifying the type of ovarian malignancy, primary or metastasis. […] Recurrence of prior malignancy is more likely than POC, but especially in patients with a history of breast cancer the risk of POC should not be disregarded.

• #2 Non-Gynecologic Causes of Adnexal/Pelvic Masses

  https://www.eurekaselect.com/article/89588

  Pelvic masses can pose a diagnostic dilemma with a broad differential to include both gynecological and non-gynecologic etiologies. […] The etiology of adnexal masses covers several subspecialties: gynecology, urology, gastroenterology, neurology, and oncology. […] For this reason, it is important for all to be aware of the differential diagnosis for pelvic masses.

• #2 What Is the Role of Laparoscopy in the Management of Adnexal Masses?

  https://www.icliniq.com/articles/womens-health/role-of-laparoscopy-in-the-management-of-adnexal-masses

  Adnexal masses originate mostly from the female reproductive system. They can also originate from the digestive or urinary systems. Numerous gynecological and nongynaecological factors can cause them. […] Most adnexal masses are caused within the female reproductive system. Some of the most common causes include: […] Ovarian cancers are the most common type of cancer seen in women. The ovarian tumor grows and spreads to other body areas when it is cancerous. […] Non-gynecologic adnexal tumors usually originate from the gastrointestinal or urinary systems. Some of the most common types include adnexal tumors of the appendix and colon. Colon and breast cancers can also spread to the pelvic region resulting in adnexal tumors.

• #2 Characterisation of Adnexal Masses | SpringerLink

  https://link.springer.com/10.1007/978-3-642-13327-5_136

  The adnexa adjoin the uterus and contain the ovaries, fallopian tubes, associated vessels, support ligaments and connective tissue. […] Pathology in the adnexa may also arise from the uterus, bowel, bladder, retroperitoneum, nerves or peritoneal metastatic deposits from another site particularly breast, stomach or colon. […] Processes that lead to development of adnexal masses include congenital masses, functional cysts, haemorrhagic lesions, neoplastic masses or inflammatory diseases. […] As treatment options will vary considerably depending on the etiology of the mass, accurate diagnosis is of paramount importance.

• #2 Adnexal tumors and masses // Middlesex Health

  https://middlesexhealth.org/6D45A9E4-E604-A092-1C3D05EBD13B3C7F

  Because so many conditions can cause adnexal tumors and masses, there are many things that can raise the risk of developing them. […] People who have gone through menopause are more likely to have an adnexal tumor or mass that is cancer than are people who haven’t gone through menopause. […] People who have used infertility medicines with hormones are at a higher risk of a cancerous adnexal tumor or mass. […] People with family members who have had breast cancer, ovarian cancer or fallopian tube cancer are at higher risk of developing a cancerous adnexal tumor or mass. […] DNA changes that raise the risk of cancer can be passed from parents to children. […] Cigarette smoking raises the risk of developing an adnexal tumor or mass that is cancer.

• #2 Adnexal Mass: Top Things to Know

  https://flo.health/menstrual-cycle/health/symptoms-and-diseases/adnexal-mass

  An adnexal mass is a lump of tissue in or near the female reproductive system, usually in an ovary or uterine tube. […] The most common reasons behind adnexal masses are ovarian cysts, ectopic pregnancies, benign tumors, and ovarian cancer. […] Ovarian cancer could also cause a pelvic mass. Ovarian cancer starts in the ovaries and spreads throughout the abdomen if undetected. […] Most pelvic masses are not cancerous. Only 5-10 percent of women will be diagnosed with one in their lifetime, and 15-20 percent of those masses are cancerous. […] The risk of a cancerous adnexal or pelvic mass increases with age, and postmenopausal people are at a greater risk than premenopausal people.

• #2 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Age is a significant independent risk factor for ovarian malignancy in the general population, with the incidence increasing sharply after the onset of menopause. […] Nulliparity, early menarche, late menopause, caucasian race, primary infertility, and endometriosis are contributing factors for a higher risk for ovarian cancer. […] The most critical personal risk factor for ovarian cancer is a strong personal or family history of breast or ovarian cancer, as they may be carriers of deleterious mutations in genes related to these two types of cancer. […] Patients with symptomatic adnexal masses, especially climacteric, have a higher risk of malignancy. […] Ovarian cancer presents nonspecific symptoms within the last 12 months mimicking irritable bowel syndrome, unspecified gastric symptoms, fatigue, and unexplained weight loss.

• #2 Adnexal mass: Symptoms, treatment, and diagnosis

  https://www.medicalnewstoday.com/articles/327525

  Risk factors depend on the cause of the adnexal mass. Females with ovarian masses have an increased risk of developing ovarian torsion. More than 80% of females with ovarian torsion have masses of 5 cm or larger. […] Ovarian cancer can run in families. People with a family history of ovarian cancer may have an increased risk of developing ovarian cancer. Other risk factors include: inherited genetic changes, hereditary nonpolyposis colorectal cancer, endometriosis, postmenopausal hormonal therapy, obesity, tall height.

• #2 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  The cyclic ovarian function of a reproductive-age women continually produces follicular growth and resorption. […] Endometriosis is a condition in which implants of normal-appearing endometrial glands and stroma are found outside their normal location in the uterine cavity. […] The most common benign cystic neoplasms of the ovary are serous and mucinous cystadenomas and cystic teratomas (dermoids). […] Malignant degeneration occurs in benign cystic teratomas in 1% to 3% of these tumors, and it is usually of a squamous type. […] The CA-125 to carcinoembryonic antigen (CEA) ratio is now being considered helpful in deciphering the site of neoplastic origin. […] The OVA1 test is a biomarker panel that measures five proteins to better classify adnexal masses to assist physicians with making referral to gynecologic cancer specialists. […] The presence and severity of symptoms are other important considerations. […] Masses that raise a suspicion for malignancy require surgical intervention.

• #2 Management of Adnexal Masses in Adolescents | Article | GLOWM

  https://www.glowm.com/article/heading/vol-2–adolescent-gynecology–management-of-adnexal-masses-in-adolescents/id/418463

  Adnexal lesions in adolescents are common and can represent ovarian or tubal pathology. […] A comprehensive history, physical exam, and appropriate investigations, as outlined below, are necessary to help identify the underlying etiology. […] Ovarian neoplasms account for 30-50% of adnexal masses within the adolescent population. The rate of malignancy is low at approximately 4%. […] Amongst pediatric and adolescent patients, germ cell tumors (GCTs) are the most common ovarian neoplasms. GCTs account for 55-70% of ovarian neoplasms in adolescents. […] Approximately 80-95% of GCTs are benign, and include mature cystic teratomas and gonadoblastoma. […] Malignant GCTs include immature teratoma, dysgerminoma, mixed GCTs, embryonal tumor, choriocarcinoma, and polyembryoma. […] Epithelial neoplasms are the second most common neoplasm in adolescent patients, accounting for 20 to 30% of ovarian neoplasms in adolescents and women under 25.

• #2 adnexal mass — Weekly Notes — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/tag/adnexal+mass

  Granulosa Cell Tumors: There are two subtypes of granulosa cell tumors: adult and juvenile. Adult type comprises 95% of these neoplasms, and generally occur in women aged 50-54 years. Juvenile type typically develops before puberty. It has a higher proliferative rate, but lower risk for late recurrences. Regardless of type, these typically present as a large, unilateral mass clinically, with a mean diameter of 12cm. They can produce estrogen and/or progesterone, so symptoms can be related to hyperestrogenism particularly in juveniles (i.e., precocious puberty). The production of estrogen in adult types is also associated with concomitant endometrial hyperplasia or cancer; with EIN present in 25-50%, and endometrial carcinoma present in 5-10% of patients. Thus, it is important to perform endometrial sampling when one of these tumors is suspected or diagnosed.

• #2 Adnexal tumor – Vejthani Hospital | JCI Accredited International Hospital in Bangkok, Thailand.

  https://www.vejthani.com/diseases-conditions/adnexal-tumor/

  Noncancerous ovarian tumors: Abnormal cell growth in the ovaries results in solid masses, occasionally with cystic components. These tumors are typically benign and do not spread to nearby tissues or other parts of the body. […] Ectopic pregnancy: When a fertilized egg implants somewhere other than the uterus, such as the fallopian tube. Ectopic pregnancies cannot be carried to term and can cause internal bleeding and intense pain. If left untreated, they can be life-threatening. […] Broad ligament leiomyoma: A leiomyoma (benign tumor) located next to the ovary and fallopian tube, often mistaken for an adnexal mass. […] Tubo ovarian abscess: Infections that affect the vaginal system can result in inflammation of the ovary, fallopian tube, and, on rare occasions, other organs including the intestine or bladder. […] Hydrosalpinx: A hydrosalpinx is an accumulation of fluid in the fallopian tube. Hydrosalpinx can cause pelvic discomfort or infertility even though it frequently shows no symptoms at all.

• #2 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Transvaginal ultrasonography (TVUS) is the single most effective way of evaluating an ovarian mass. […] Tumor markers can be used alone or in combination with imaging tests and clinical information for the differential diagnosis of adnexal masses. […] The CA125 transmembrane glycoprotein is elevated in 80% of ovarian carcinomas, especially in advanced tumors. […] The effectiveness of using panels of biomarkers combined with clinical and radiologic evaluation for the distinction between benign and malignant adnexal masses has been studied. […] The risk of malignancy index (RMI) algorithm combines the value of CA 125 serum levels, ultrasound, and menopausal status. […] The incidence of adnexal masses in childhood and adolescence is very low, higher in the first year of life due to hormonal phenomena in utero, and rises again close to menarche.

• #2 Adnexal Diseases | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-031-27355-1_15

  The role of additional imaging is to confirm benign diagnoses and to detect those lesions that are borderline or malignant in nature in order to ensure the patients are managed by the appropriate gynaecological oncology teams. […] Ultrasound is considered the first-line imaging modality to characterise adnexal masses as benign or malignant. […] The usage of MRI is widely adopted by many national guidelines for characterisation of sonographically indeterminate adnexal masses. […] Numerous studies have shown that MRI has the highest diagnostic accuracy among imaging modalities with pooled sensitivity of 0.94 and specificity of 0.91 for differentiating malignant from benign adnexal tumours. […] Most adnexal masses discovered incidentally in pre- and postmenopausal women will be benign.

• #2 Management of the Adnexal Mass | Obgyn Key

  https://obgynkey.com/management-of-the-adnexal-mass-2/

  Though currently there are no validated biomarkers for ovarian cancer screening, the use of CA-125 level has been extensively studied. CA-125 is a glycoprotein that is produced by the ovary, peritoneal, and pleural linings. Although it is frequently elevated in malignant conditions, it can also be increased with benign processes, such as endometriosis and PID. In contrast, patients with early-stage epithelial ovarian carcinoma or borderline tumors may present with a normal CA-125 value.24 However, when assessing a patients risk of malignancy, this value may contribute to management decisions.

• #2 Adnexal masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses-2/

  Age is probably the most important factor for predicting the potential for malignancy. […] The differential diagnosis of an adnexal mass varies with the age of the patient. […] Although most malignant ovarian tumors arise de novo, strong inferential evidence shows that at least some benign tumors will become malignant. […] The morphologic complexity on ultrasonography coupled with CA-125 level elevations makes endometriotic cysts among the most common masses incorrectly thought to be suspicious for malignancy on workup. […] An elevated serum CEA level should raise suspicion for GI malignancy, particularly when the CA-125 to CEA ratio is less than 25.

• #2 Female Pelvic Mass – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/symptoms-of-gynecologic-disorders/female-pelvic-mass

  Pelvic masses may originate from the upper female reproductive tract (ovaries, fallopian tubes, uterus, and cervix) or from other pelvic structures (intestines, ureters). […] The etiology, diagnosis, and treatment of a female pelvic mass vary by reproductive phase or status: premenarche, reproductive age, pregnancy, or menopause. […] The types of female reproductive tract masses are mostly the same for reproductive-aged and menopausal women. However, certain masses are stimulated by estrogen. […] Adnexal masses can be difficult to evaluate fully with imaging alone. […] Adnexal masses with features or blood tests that suggest malignancy are not evaluated with biopsy, because performing a biopsy may spread malignant cells. […] The approach to management of adnexal masses includes the following: Simple ovarian cysts. […] Referral to a gynecologic oncologist is recommended if there is a high risk of malignancy (typically recommended for postmenopausal women with an elevated CA 125 or premenopausal women with a very elevated CA 125 and ultrasound findings suggestive of malignancy).

• #2 Management of Adnexal Masses in Adolescents | Article | GLOWM

  https://www.glowm.com/article/heading/vol-2–adolescent-gynecology–management-of-adnexal-masses-in-adolescents/id/418463

  Endometriomas are benign ovarian masses of ectopic endometrial tissue. […] Lesions within the adnexa can represent both congenital and acquired etiologies. […] Accurate pre-operative risk assessment of malignancy remains an active area of investigation within pediatric and adolescent gynecology. […] Several ultrasound characteristics predictive of malignancy have been identified. […] For suspected malignancies, intervention usually includes surgical staging with possible exploration, pelvic washings, unilateral salpingoopherectomy, sampling of suspected pathological lymph nodes, peritoneal sampling and omental biopsy.

• #2 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  Adnexal masses are common, and careful evaluation is required before a therapeutic intervention is planned. […] Masses are classified based on the workup for risk of malignant potential. Of all the variables, age is probably the most predictive of cancer. […] There are many markers that help in determining how likely the mass represents a cancer, and these should be considered preoperatively. […] It is important to be prepared for the possibility that any mass is malignant. […] The overwhelming majority of adnexal masses are benign, and it is important to determine preoperatively whether a patient is at high risk for ovarian malignant disease to minimize the number of operative procedures performed for self-limited processes. […] The risk of malignancy and the fundamental concept that early diagnosis and treatment in cancer are related to reduced mortality and morbidity propel the system.

• #2 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Adnexal masses occurred in women of all age groups, and their etiology and frequency vary age accordingly. […] The adnexal mass may come from functional or physiological changes, inflammatory processes, endometriosis, benign and malignant tumor. […] The incidence and mortality due to ovarian cancer have remained stable over the past three decades and represent the leading cause of death from malignant neoplasm of the female genital tract in developed countries. […] The mainstream to management of adnexal masses is excluding malignancies. […] The characterization of malignancy findings on the image (TVUS or MRI) is the key since women with ovarian cancer should preferably be treated in oncological referral centers as soon as possible. […] Estimate the malignancy risk index is essential to assess an adnexal mass.

• #3 Adnexal tumors and masses – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/adnexal-tumors-and-masses/

  Adnexal tumors and masses are growths of cells that form on the organs and connective tissue around the uterus. Adnexal tumors and masses most often aren’t cancer, but they can be cancer. […] There are many possible causes of adnexal tumors and masses. Causes that are more common include: […] Cysts can happen within the ovaries and fallopian tubes as well as in the connective tissue around them. […] Endometriosis happens when tissue that is similar to the inner lining of the uterus grows outside the uterus. […] An ectopic pregnancy happens when a fertilized egg implants and grows outside the main cavity of the uterus, most often in a fallopian tube. […] Most adnexal tumors and masses are not cancer. But some may be cancer that affects the ovaries, fallopian tubes or the tissue around them.

• #3 Adnexal Tumors: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/258044-overview

  The normal functioning ovary produces a follicular cyst 6-7 times each year. In most cases, these functional cysts are self-limiting and resolve within the duration of a normal menstrual cycle. In rare situations, a cyst persists longer or becomes enlarged. At this point, it represents a pathological adnexal mass. […] Since ovaries produce physiologic cysts in menstruating women, the likelihood of a benign process is higher in women of reproductive age. In contrast, the presence of an adnexal mass in prepubertal girls and postmenopausal women heightens the risk of a malignant neoplastic etiology. […] The pathophysiology is not well understood for most adnexal masses; however, some theories have been proposed. Functional cysts may be the result of variation in normal follicle formation. Mature cystic teratoma may be the result of abnormal germ cell proliferation. Endometriomas are thought to result from retrograde menstruation or coelomic metaplasia. The exact cause of epithelial neoplasms is unknown, but recent studies have suggested a complex series of molecular genetic changes is involved.

• #3 ADNEXAL MASSES & OVARIAN CYSTS – Dr. Charles E. Miller

  https://drcharlesmiller.com/gynecologic/adnexal-masses-ovarian-cysts/

  Cystadenoma This is a common benign tumor that can contain serous or mucinous fluid within the cyst. […] Other benign tumors of the ovary There are other tumors of the ovary that are benign, but some may produce increased levels of different types of hormones, such as estrogen (Granulosa cell tumor), androgens or male hormones (Sertoli-Leydig cell tumors) or thyroid hormone (Struma Ovarii). […] Cancer Cancer may develop in the ovary or fallopian tube. Other cancers, especially from breast and the gastrointestinal tract, may spread to the adnexal region as well.

• #3 The etiology of adnexal masses in women with a history of non-gynaecological malignancy: recurrence, second, primary or none? – Journal of the Turkish-German Gynecological Association

  https://www.jtgga.org/articles/the-etiology-of-adnexal-masses-in-women-with-a-history-of-non-gynaecological-malignancy-recurrence-second-primary-or-none/doi/jtgga.galenos.2021.2021-0031

  Adnexal masses are usually incidentally diagnosed during the follow-up of patients with a history of non-gynaecological malignancy (NGM). For these patients, the occurrence of an adnexal mass raises concerns for malignancy, either primary or metastasic, but the overall risk is not clearly defined. The prognosis and treatment depend on the etiology. […] Ovarian metastasis is usually associated with an advanced, incurable disease and needs only palliative systemic therapy. In contrast, primary ovarian cancer (POC) is a potentially curable disease and the standard treatment is surgery followed by systemic chemotherapy. […] Metastasis comprises 5-20% of all ovarian neoplasms and the most common non-gynecological source is gastrointestinal tract cancer (57%), followed by breast cancer (30%).

• #3 Mayo Clinic Health Library – Adnexal tumors and masses | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20212893

  Because so many conditions can cause adnexal tumors and masses, there are many things that can raise the risk of developing them. […] People who have gone through menopause are more likely to have an adnexal tumor or mass that is cancer than are people who haven’t gone through menopause. […] People who have used infertility medicines with hormones are at a higher risk of a cancerous adnexal tumor or mass. […] People with family members who have had breast cancer, ovarian cancer or fallopian tube cancer are at higher risk of developing a cancerous adnexal tumor or mass. […] Cigarette smoking raises the risk of developing an adnexal tumor or mass that is cancer.

• #3 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Age is a significant independent risk factor for ovarian malignancy in the general population, with the incidence increasing sharply after the onset of menopause. […] Nulliparity, early menarche, late menopause, caucasian race, primary infertility, and endometriosis are contributing factors for a higher risk for ovarian cancer. […] The most critical personal risk factor for ovarian cancer is a strong personal or family history of breast or ovarian cancer, as they may be carriers of deleterious mutations in genes related to these two types of cancer. […] Patients with symptomatic adnexal masses, especially climacteric, have a higher risk of malignancy. […] Ovarian cancer presents nonspecific symptoms within the last 12 months mimicking irritable bowel syndrome, unspecified gastric symptoms, fatigue, and unexplained weight loss.

• #3 Adnexal Tumors: Practice Essentials, History of the Procedure, Problem

  https://emedicine.medscape.com/article/258044-overview

  Overall, approximately 10% of ovarian cancers are hereditary. As such, patients with a history suggestive of a hereditary breast-ovarian cancer syndrome (BRCA1 or BRCA2) or hereditary nonpolyposis colorectal cancer syndrome (HNPCC or Lynch syndrome) are at increased risk for developing a malignant mass. […] The major adverse outcomes in the treatment of adnexal masses are related to complications resulting from surgical therapy.

• #3 adnexal mass — Weekly Notes — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/tag/adnexal+mass

  Thecomas: Thecomas are solid, fibromatous, generally benign neoplasms. They are generally unilateral, and are comprised of theca cells. The theca cells appear in normal ovulation as follicles develop into secondary follicles, and under the influence of LH produce androgens. After ovulation, theca cells also help to form the corpus luteum with granulosa cells. Because of this high production of androgen that will be converted, endometrial hyperplasia or cancer can also be found in these patients, and it is wise to perform endometrial sampling for that reason. Up to 20% of patients may have synchronous endometrial cancer. […] Fibromas: These are the most common type of sex cord stromal tumor. They are benign, solid, unilateral neoplasms, generally occurring in postmenopausal women, and are not hormonally active. However these can be implicated in Meigs syndrome, where the tumor is associated with extensive ascites or a pleural effusion.

• #3 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  The cyclic ovarian function of a reproductive-age women continually produces follicular growth and resorption. […] Endometriosis is a condition in which implants of normal-appearing endometrial glands and stroma are found outside their normal location in the uterine cavity. […] The most common benign cystic neoplasms of the ovary are serous and mucinous cystadenomas and cystic teratomas (dermoids). […] Malignant degeneration occurs in benign cystic teratomas in 1% to 3% of these tumors, and it is usually of a squamous type. […] The CA-125 to carcinoembryonic antigen (CEA) ratio is now being considered helpful in deciphering the site of neoplastic origin. […] The OVA1 test is a biomarker panel that measures five proteins to better classify adnexal masses to assist physicians with making referral to gynecologic cancer specialists. […] The presence and severity of symptoms are other important considerations. […] Masses that raise a suspicion for malignancy require surgical intervention.

• #3 O-RADS MRI to classify adnexal tumors: from clinical problem to daily use | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-023-01598-0

  The unmet clinical need refers to the challenge of accurately identifying malignant (cancerous) adnexal masses during ultrasound (US) examinations. […] As a result, there is a risk of false-positive cases, where patients might undergo unnecessary cancer surgeries due to the uncertainty surrounding the diagnosis. […] MRI is known for its excellent soft tissue contrast and ability to provide detailed images of internal organs, making it a valuable tool in diagnosing adnexal masses. […] Despite the amount of evidence in the literature, at that time, there was no translation into clinical practice and the need for standardization of the model of the RADS system to have an impact on the management of patients existed. […] The MR score was accurate when stratifying the risk of malignancy in adnexal masses with a sensitivity of 0.93 and a specificity of 0.91, reproducible with a high interrater agreement among both experienced and junior readers.

• #3 Management of the Adnexal Mass | Obgyn Key

  https://obgynkey.com/management-of-the-adnexal-mass-2/

  In addition to the symptoms discussed in the preceding paragraph, other presenting complaints, when combined with the finding of an adnexal mass, may point to less common types of ovarian neoplasms. Estrogen-secreting tumors, such as granulosa cell tumors or a thecomas, should be considered in women with an adnexal mass, abnormal uterine bleeding, and breast tenderness, or precocious puberty in prepubertal females.1012 In contrast, Sertoli-Leydig tumors, which secrete testosterone, often present with symptoms such as hirsutism and deepening of the voice.13 Other rare findings may include symptoms of hyperthyroidism in patients with a struma ovarii or symptoms such as flushing, diarrhea, and palpitations in women with a carcinoid tumor of the ovary. […] The use of tumor markers may aid in determining the malignant potential and histology of an adnexal mass. Typically elevated in patients who are ultimately diagnosed with cancer, the utility of tumor markers may be helpful in the initial diagnosis, monitoring of response to treatment, and triaging to the appropriate specialist. However, tumor markers should be ordered selectively, and physicians should take into account the patients age, presentation of symptoms, findings on physical examination, and imaging.

• #3 Adnexal tumors and masses – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/adnexal-tumors-and-masses/

  People who have gone through menopause are more likely to have an adnexal tumor or mass that is cancer than are people who haven’t gone through menopause. […] People who have used infertility medicines with hormones are at a higher risk of a cancerous adnexal tumor or mass. […] People with family members who have had breast cancer, ovarian cancer or fallopian tube cancer are at higher risk of developing a cancerous adnexal tumor or mass. […] DNA changes that raise the risk of cancer can be passed from parents to children. […] Cigarette smoking raises the risk of developing an adnexal tumor or mass that is cancer.

• #3 Lesions of the Ovary and Fallopian Tube – Mass General Advances in Motion

  https://advances.massgeneral.org/obgyn/journal.aspx?id=2369

  Lesions of the adnexa (ovary or fallopian tube) are common and span a wide differential diagnosis with a spectrum of benign to malignant causes. […] Lesions of the ovary and fallopian tube (together, the adnexa) are common throughout the life cycle and have many causes, from benign to malignant. […] Older age is the greatest independent risk factor for adnexal cancer. Family history is another critical component of the history-taking, as 20% of ovarian and tubal cancers are due to a heritable gene mutation. […] Multiple studies have shown that for women with high-risk adnexal lesions, comprehensive surgical staging and tumor debulking are associated with increased survival.

• #4 Evaluation of the Adnexal Mass in an Older Patient

  https://exxcellence.org/pearls-of-exxcellence/list-of-pearls/evaluation-of-the-adnexal-mass-in-an-older-woman/

  Age is the most significant risk factor for ovarian cancer, with a lifetime risk for ovarian cancer of 1 in 70. […] Serum markers such as Cancer Antigen 125 (CA125), Human Epididymis 4 (HE4) and newer Multivariate Index Assays (OVA1, OVA2, ROMA) are added tools to evaluate adnexal masses. CA125 can be elevated in both benign and malignant conditions. CA125 and HE4 together may have improved diagnostic value for differentiating benign and malignant masses. […] If the tumor is 5 cm or there is any evidence of papillary projections or ascites, the patient should be referred to a gynecologic oncologist.

• #4 SciELO Brazil – Adnexal mass: diagnosis and management Adnexal mass: diagnosis and management

  https://www.scielo.br/j/rbgo/a/YWRftRYFPKQ3rtjjHWGHFYB/

  Age is a significant independent risk factor for ovarian malignancy in the general population, with the incidence increasing sharply after the onset of menopause. […] Nulliparity, early menarche, late menopause, caucasian race, primary infertility, and endometriosis are contributing factors for a higher risk for ovarian cancer. […] The most critical personal risk factor for ovarian cancer is a strong personal or family history of breast or ovarian cancer, as they may be carriers of deleterious mutations in genes related to these two types of cancer. […] Patients with symptomatic adnexal masses, especially climacteric, have a higher risk of malignancy. […] Ovarian cancer presents nonspecific symptoms within the last 12 months mimicking irritable bowel syndrome, unspecified gastric symptoms, fatigue, and unexplained weight loss.

• #4 adnexal mass — Weekly Notes — CREOGS Over Coffee

  https://creogsovercoffee.com/notes/tag/adnexal+mass

  Sertoli / Leydig Cell Tumors: These two are the rarest of the sex cord stromal tumors, accounting for less than 0.5% of these. The histopathology of the hollow tubules (Sertoli) surrounded by fibrous stroma (Leydig) is classic. These will often produce androgens and be associated with virilizing symptoms. They also are unilateral and are often associated with large masses, with a mean size of 16cm at presentation. AFP is often another marker.

• #5 Adnexal Masses | Oncohema Key

  https://oncohemakey.com/adnexal-masses/

  Detection of pelvic abnormalities is more frequent in women of reproductive age because these patients have serial examinations as part of periodic screening for cancer. […] The differentiation between benign and malignant ovarian enlargements is often the exclusive decision of the pathologist, but a short discussion of these lesions is pertinent even in a textbook of oncology. […] Although it is not known whether malignant ovarian tumors arise de novo or develop from benign tumors, there is strong inferential evidence that at least some benign tumors will become malignant. […] The most common entity of the GI tract that initially appears to be an adnexal mass is fecal material in the sigmoid colon or cecum, which may on initial pelvic examination be palpated as a soft, mobile, tubular mass.

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