Materiały źródłowe

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

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

  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. Some of the more common causes are: […] Ovarian cancer. When an ovarian tumor is malignant (cancerous), it can grow and spread to other areas of your body. […] These masses usually originate in the urinary or digestive systems. These types have nothing to do with your uterus, ovaries or fallopian tubes. […] Most adnexal masses aren’t serious. Only a healthcare provider can determine if a mass is something to worry about. Adnexal masses aren’t typically cancerous and don’t usually long-term or life-threatening complications.

• #2 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. […] With no effective screening measures available, 70% of ovarian malignancies are diagnosed at a late stage. […] However, when ovarian cancer is detected at a stage confined to the ovary, survival rates can approach 90% at five years. […] The differential diagnosis for adnexal masses is broad. […] Because adnexal masses can have gastrointestinal, urinary, or metastatic sources, ovarian origin should not be assumed.

• #3 Diagnosis and Management of Adnexal Masses | AAFP

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

  In postmenopausal women, 30 percent of adnexal masses are malignant. […] Adnexal masses are characterized on ultrasonography as cystic, solid, or complex. […] Findings that suggest malignancy include CA 125 level greater than 35 U per mL (postmenopausal) or 200 U per mL (premenopausal); evidence of abdominal or distant metastasis; family history of first-degree relative with ovarian or breast cancer; nodular or fixed pelvic mass (postmenopausal); and concerning ultrasonography findings, including a solid component, thick septations (greater than 2 to 3 mm), bilaterality, Doppler flow to the solid component of the mass, and presence of ascites. […] The U.S. Preventive Services Task Force recommends against routine screening for ovarian cancer, including use of transvaginal ultrasonography, cancer antigen (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. […] If ovarian cancer is diagnosed, CA 125 level is used to monitor the patient’s response postoperatively.

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

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

  But some causes of adnexal masses do have serious complications. The causes of tumors that do carry risks of serious complications are: […] No. Most adnexal tumors are benign (noncancerous). But a small percentage are malignant (cancerous). Your risk for having a malignant adnexal tumor increases after menopause. […] Treatment for adnexal masses depends on the specific cause. There are generally three options for treatment: […] The treatment your provider recommends is unique to you, the type of growth you have and how big it is. Many factors go into determining your treatment plan. Generally, a solid mass is more concerning than a fluid-filled mass. […] If you have an adnexal mass, your healthcare provider will recommend a treatment plan that’s unique to your situation. Oftentimes, adnexal tumors go away on their own without any treatment. […] Most adnexal tumors aren’t 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).

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

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

  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.

• #6 eMedicine – Adnexal Tumors : Article by Nelson Teng, MD, PhD

  https://www.csh.org.tw/dr.tcj/educartion/f/web/Adnexal%20Tumors/index.htm

  Functional cysts are the result of variation of normal follicle formation. […] Adult cystic teratomas (dermoid) are the result of an abnormal germ cell. […] 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.

• #7 eMedicine – Adnexal Tumors : Article by Nelson Teng, MD, PhD

  http://www.csh.org.tw/dr.tcj/Educartion/f/web/Adnexal%20Tumors/index.htm

  During the course of her lifetime, every woman develops several adnexal masses. […] The pathophysiology is not well understood for most adnexal masses; however, the following are some theories: […] Functional cysts are the result of variation of normal follicle formation. […] Adult cystic teratomas (dermoid) are the result of an abnormal germ cell. […] 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.

• #8 Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation

  https://www.mdpi.com/1422-0067/22/10/5077

  Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. […] The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors. […] The pathogenesis is not known. […] Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. […] Other DNA mutations were also reported, including abnormalities commonly found in other cancers, such as EGFR (epidermal growth factor receptor), HRAS (HRas Proto-Oncogene, GTPase), TP53, RB1 (retinoblastoma protein), ATM (ATM Serine/Threonine Kinase), and PIK3CA (Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunit Alpha).

• #9 Serine/threonine kinase 11 (STK11) associated adnexal tumors: from biology to therapeutic impact | Human Genomics | Full Text

  https://humgenomics.biomedcentral.com/articles/10.1186/s40246-025-00741-w

  Female adnexal malignancies, while relatively uncommon, exhibit high mortality rates due to often-late diagnosis. The serine/threonine kinase 11 (STK11) is a tumor suppressor gene, and its inactivation or mutation often leads to an autosomal dominant genetic disorder known as Peutz-Jeghers syndrome (PJS), which is associated with ovarian and cervical cancers. STK11-associated adnexal tumors mostly originate from the ovary, with a low incidence rate but high metastasis rates worldwide. […] The rare pathological features, differentiation patterns and poor prognosis of STK11-associated tumors highlight the necessity of relevant screening policy or targeted therapy in addition to surgery and chemotherapy. […] The genetic susceptibility of OC has always been the focus of attention. Germline mutations in more than 10 genes have been associated with hereditary OC, primarily BRCA1/2.

• #10

  https://journals.lww.com/ijdv/fulltext/2023/03000/malignant_cutaneous_adnexal_tumor_in_posterior.12.aspx

  The most common cutaneous adnexal tumors in children were follicular, especially pilomatricoma, and a few were predominant glandular/ductal differentiation, malignant forms are occasionally encountered. […] Hidradenocarcinoma is a rare aggressive malignant tumor of the eccrine glands, and was first reported as clear cell eccrine carcinoma by Keasby and Hadley in 1954. […] The pathogenesis remained unknown, but it has been suspected that it was related to translocation or mutation of gene, such as mastermind-like transcriptional coactivator 2 translocation and mutations of two potentially targetable gene: PTCH1 and TCF7L1. […] The histopathology showed infiltrative growth pattern, deep extension, necrosis, nuclear pleomorphism, mitoses, desmoplastic stromal reaction and the clear cell area and adenoid differentiation.

• #11 Serine/threonine kinase 11 (STK11) associated adnexal tumors: from biology to therapeutic impact | Human Genomics | Full Text

  https://humgenomics.biomedcentral.com/articles/10.1186/s40246-025-00741-w

  The cancer risk for PJS patients is about 18 times higher than that of the general population, with approximately 85% of malignant tumors occurring before the age of 70. In gynecological diseases, PJS is considered a promoting factor for SCTATs, MDA, and LEGH, as previously mentioned. […] The main causes of STK11 inactivation or mutation include nonsense mutations, missense mutations, frameshift mutations, and splice site mutations. […] It has been reported that the loss of STK11 in primary and immortal cells of TP53 mutants induces premature cellular senescence and causes G2/M cell cycle arrest. This suggests that STK11 may affect cell polarity and differentiation, as well as promote oncogenic transformation. […] Most studies have established correlations between STK11 and cancers of the lung, pancreas, stomach, and colorectal regions, while STK11-associated gynecological oncology (GO) primarily involves SCTATs and MDA.

• #12 Pathology Outlines – Wolffian tumor / Female adnexal tumor of probable Wolffian origin

  https://www.pathologyoutlines.com/topic/ovarytumorfatwo.html

  Adnexal tumor arising from remnants of Wolffian (mesonephric) duct […] Adnexal tumor arising from mesonephric (Wolffian duct) remnants […] Believed to originate from mesonephric (Wolffian) duct remnants […] Arises along the trajectory of the Wolffian duct: from the ovarian hilum, along mesosalpinx, broad ligament, lateral aspects of the uterus and cervix, to the outer third of the vagina […] Most tumors behave in a benign fashion, although some tumors exhibit aggressive behavior. […] Although features known to be associated with adverse prognosis (e.g., large size, capsular invasion, rupture, high cellularity, nuclear pleomorphism, high mitotic activity) are absent in this case, cases without these features may also recur.

• #13

  https://link.springer.com/article/10.1007/s13691-012-0021-6

  Female adnexal tumors of probable Wolffian origin (FATWOs) are rare neoplasms that originate from remnants of the Wolffian duct. […] FATWOs have specific pathological characteristics similar to those of remnants of the Wolffian duct. […] Although approximately 85 cases of FATWOs, including 11 malignant cases, have been reported as of today, most of them discuss pathologic features of these tumors. […] It is usually hard, before an operation, to confirm the diagnosis of FATWOs because they have no specific tumor markers or features on scanning images. […] The belief that they are of mesonephric origin is based on (a) the location of the tumor mass detected at the same site as mesonephric remnants, (b) their morphological dissimilarity to other ovarian tumors of either epithelial-stromal or sex cord-stromal types, and (c) some ultrastructural and immunohistochemical homology with the mesonephric duct.

• #14 Clinicopathological Study of Skin Adnexal Tumors with Special Emphasis on the Line of Differentiation

  https://jmsh.ac.in/articles/clinicopathological-study-of-skin-adnexal-tumors-with-special-emphasis-on-the-line-of-differentiation

  Skin adnexal tumors are amalgamating group of primary skin tumors. […] The skin adnexal neoplasms are classified into sub-groups, depending on their differentiation towards hair follicles, sebaceous, apocrine and eccrine glands. […] This doctrine explains the fact that adnexal neoplasm can resemble their mature counterparts and different histopathological appearance in the same tumor would be precisely because of multiple differentiation pathways of stem cells. […] These tumors basically originate from undifferentiated pluripotent stem cells, determining its preponderance to behave in a benign fashion. […] These tumors are influenced by genetics, local vascularity, and microenvironment of epidermis dermis in its malignant transformation. […] The pathological outcome for this morphological classification emphasized on a better understanding of the morphology of skin adnexal tumors under the microscope. […] This study therefore signified that histopathological examination, thus forms a sole and an essential tool in studying the skin adnexal tumors, owing to its indistinctive clinical presentation.

• #15 Rapid rate of growth in adnexal masses, despite benign appearance on ultrasound, was associated with malignancy. A retrospective analysis of 48 consecutive cases from a single institution

  https://www.imrpress.com/journal/CEOG/48/5/10.31083/j.ceog4805174/htm

  Rapid rate of growth in adnexal masses, despite benign appearance on ultrasound, was associated with malignancy. […] Despite benign appearance on ultrasound and low RMI, adnexal masses with a rapid rate of growth were associated with a risk of malignancy of 9.3%. […] A factor which we noted to be associated with malignancy in our consecutive series of patients operated for benign appearing adnexal masses was the rate of growth. Patients in whom the adnexal mass had grown by over 50% in 6–12 months prior to surgery or in whom the adnexal mass first appeared 6–12 months prior to surgery had a higher likelihood of malignant histology as compared to those in whom the adnexal mass had been growing at a slower pace. The rate of malignancy was 9.3%. This observation is biologically plausible since most ovarian cancers grow rapidly and present in advanced stages. Despite lack of elevated CA-125 levels or Risk of Malignancy Index and despite benign ultrasound features, rapid growth was associated with a high likelihood of malignancy.

• #16 Adnexal masses | Oncohema Key

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

  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. […] 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. […] 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. […] Malignant neoplasms may have the same fate. Indeed, one of the most unfortunate features of benign ovarian neoplasms is that they are frequently indistinguishable clinically from their malignant counterparts. […] It was once dogma that a postmenopausal patient with any enlargement of the ovary be considered to have cancer until proven otherwise. […] The nature and severity of the pain and other associated symptoms frequently lead to operative intervention, irrespective of the risk for malignancy. […] Malignancy is more commonly associated when a cyst wall or septation is thickened or has nodularity, or the cyst contains solid components.

• #17 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. […] There is no effective screening method for ovarian cancer that has been shown to significantly improve clinical outcomes. […] When ovarian cancer does occur, it tends to do so in prepubescent girls and in post-menopausal women.

• #18 Pathological features of persistent adnexal masses in pregnancy

  https://atm.amegroups.org/article/view/72364/html

  The composition of pelvic masses during pregnancy is complex, and over 70% of masses are physiology. […] Determining the source and nature of tumor tissue is incredibly important in clinical practice, as the proportion of metastatic and low-grade tumors in adnexal masses increase during pregnancy. […] A significant difference in tumor pathology distribution was noted between those who underwent emergency surgery during pregnancy, elective surgery during pregnancy, and simultaneous tumor removal during cesarean section. […] A special particularity exists in the pathology distribution of persistent adnexal masses in pregnancy. […] Additionally, extensive histological sources and the need to rule out borderline/malignancy for solid cystic tumors were noted. […] The results showed that the pathological distribution and tissue source of masses during pregnancy were particularly different from those during non-pregnancy.

• #19 Pathological features of persistent adnexal masses in pregnancy

  https://atm.amegroups.org/article/view/72364/html

  The malignant tumor proportion was 3.51%; this figure is similar to that reported in other literature. […] The results of this study showed an extensive source of pathological tissue for persistent adnexal masses in pregnancy. […] The proportion of metastatic ovarian tumors, which endanger patients lives, was higher in pregnant women than non-pregnant women. […] Thus, malignant tumors in pregnancy led to a poorer prognosis. […] Determining the source of newly found tumors in pregnancy is very important. […] Both tumor and fetal factors need to be taken into consideration when deciding treatment. […] Thus, an active surgical exploration is the best choice for abdominal emergencies, suspected mass pedicle torsion, and suspected borderline/malignant tumors.

• #20

  https://www.ijrcog.org/index.php/ijrcog/article/view/12445

  Adnexal mass is a common clinical presentation among women of all age groups and is extremely common among reproductive age groups. […] The differential diagnosis of adnexal mass is complex and includes benign and malignant ovarian tumors, functional cysts, para ovarian cysts, tubo-ovarian abscess, ectopic pregnancy, hydrosalpinx, fimbrial cyst, tubal malignancies, broad ligament fibroid. […] Among them 48% have benign lesions and 51% have malignant lesions. […] Serous cystadenoma and simple serous cyst (25%) were common benign lesions and most common malignant lesion was serous cystadenocarcinoma.

• #21

  https://www.ijrcog.org/index.php/ijrcog/article/view/676

  The aim of this study was to detect and determine the origin of adnexal mass and to narrow down the diagnosis. […] Differential diagnosis of adnexal mass is difficult and complex. […] 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%). […] 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.

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

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

  Thanks for sticking with us until the end of this adnexal mass journey! Today were going to cover some rare tumors that always find themselves on CREOGs the sex cord stromal tumors. These only comprise about 1.2% of primary ovarian cancers. Most people are fortunately diagnosed at an early stage due to the fact that symptoms tend to be much more overt with these types of tumors. […] 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.

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

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

  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. […] 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.

• #24 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. […] Diagnosis of adnexal tumors and masses involves a careful physical exam, imaging tests and blood tests. Treatment depends on the size of the tumor or mass and its cause. […] There are many possible causes of adnexal tumors and masses. Causes that are more common 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. […] Because so many conditions can cause adnexal tumors and masses, there are many things that can raise the risk of developing them. But it’s most important to be aware of factors that can affect the risk of an adnexal tumor or mass being cancer, including:

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

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

  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. But those who have used hormonal birth control are at a much lower risk of an adnexal tumor or mass being cancer. […] 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. These changes can greatly raise the risk of getting some cancers. But not everyone with these DNA changes gets cancer. […] Cigarette smoking raises the risk of developing an adnexal tumor or mass that is cancer.

• #26 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. […] With no effective screening measures available, 70% of ovarian malignancies are diagnosed at a late stage. […] However, when ovarian cancer is detected at a stage confined to the ovary, survival rates can approach 90% at five years. […] The differential diagnosis for adnexal masses is broad. […] Because adnexal masses can have gastrointestinal, urinary, or metastatic sources, ovarian origin should not be assumed.

• #27 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. […] Studies have investigated the creation of a symptom index to evaluate the constellation of possible indicators and their presence over time, but no single index is widely accepted. […] Clinicians should maintain a high index of suspicion for ovarian cancer in women with abdominal or pelvic symptoms, especially if the symptoms are new or progressive. […] Transvaginal ultrasonography is the first choice for imaging to differentiate between a benign and a malignant adnexal mass, with a sensitivity of 93.5% and a specificity of 91.5%. […] Risk of ovarian malignancy increases with ovarian mass size greater than 6 cm, bilaterality, septation, and presence of ascites. […] Gynecologic oncologists are trained to appropriately stage and debulk ovarian cancers.

• #28 Diagnosis and Management of Adnexal Masses | AAFP

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

  In postmenopausal women, 30 percent of adnexal masses are malignant. […] Adnexal masses are characterized on ultrasonography as cystic, solid, or complex. […] Findings that suggest malignancy include CA 125 level greater than 35 U per mL (postmenopausal) or 200 U per mL (premenopausal); evidence of abdominal or distant metastasis; family history of first-degree relative with ovarian or breast cancer; nodular or fixed pelvic mass (postmenopausal); and concerning ultrasonography findings, including a solid component, thick septations (greater than 2 to 3 mm), bilaterality, Doppler flow to the solid component of the mass, and presence of ascites. […] The U.S. Preventive Services Task Force recommends against routine screening for ovarian cancer, including use of transvaginal ultrasonography, cancer antigen (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. […] If ovarian cancer is diagnosed, CA 125 level is used to monitor the patient’s response postoperatively.

• #29 Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation

  https://www.mdpi.com/1422-0067/22/10/5077

  The ultimate goal is excision with clear (R0) surgical margins. […] The therapeutic approach to malignancies is surgical intervention, including WLE, MMS, or amputation. […] The role of adjuvant therapy remains unclear. Most tumors are resistant to radiotherapy and chemotherapy. […] The therapeutic approach includes standard surgical resection and WLE. […] Complete resection seems to be the optimal therapeutic approach for benign lesions.

• #30 Role of minimally invasive surgery in complex adnexal tumours and ovarian cancer

  https://www.wjgnet.com/2218-6220/full/v3/i3/109.htm

  The role of laparoscopy has been widely used in cervical and endometrial cancer due to its known clinical benefits such as magnification of the operative field, reduced intraoperative and postoperative complications, less intraoperative blood loss, and a shorter postoperative recovery. Nevertheless, the laparoscopic approach for the staging of ovarian cancer and management of suspicious adnexal masses has raised several concerns among gynaecological oncologists such as a possible reduction in radical surgical excision, an increased risk of port-site metastases or a higher recurrence rate related to more frequent intra-operative tumour cyst rupture. […] The laparoscopic approach for surgical staging or restaging of ovarian cancer was first reported in the mid 1990s. When considering a minimally invasive approach it is of utmost importance to perform an accurate preoperative evaluation and to define the rules for surgical management of adnexal masses.

• #31 Role of minimally invasive surgery in complex adnexal tumours and ovarian cancer

  https://www.wjgnet.com/2218-6220/full/v3/i3/109.htm

  Ovarian cancer is one of the most common causes of cancer-related death in women. Adnexal masses are frequently diagnosed during reproductive age and often require surgical removal. The risk of malignancy when dealing with a complex adnexal mass should be defined prior to surgery and several scoring systems may be useful for this purpose. […] In the last decade concerns have been raised regarding the risk of cyst rupture and tumour spillage as a consequence of the laparoscopic technique itself both in early and advanced stages of ovarian cancer. Although limited data have been reported in the literature on the use of minimally invasive techniques in ovarian cancer, the clear benefits of this approach must be balanced with the potential hazards in different clinical situations. […] The precise role of laparoscopy in patients with more advanced cancer is still to be defined, and the risk of suboptimal surgery should never outweigh the potential benefits of minimally invasive surgery. Thus, a tailored prediction of optimal laparoscopic debulking is mandatory in these patients.

• #32 Laparoscopic management of selected solid adnexal tumors | Gynecological Surgery | Full Text

  https://gynecolsurg.springeropen.com/articles/10.1007/s10397-006-0189-x

  Fourteen cases of laparoscopically treated solid/predominantly solid nonepithelial adnexal tumors are presented. […] With the advent of surgical equipment and techniques in laparoscopy, ovarian tumors are now commonly managed by laparoscopy if conditions are suspected to be benign. […] However, laparoscopic surgery for either suspicious or malignant conditions remains controversial. […] Cases of solid/predominantly solid adnexal tumor first diagnosed by ultrasonography include various natures of neoplastic conditions from benign to malignant, and laparotomy is the usual approach to such cases. […] However, if cases are appropriately selected by careful evaluation of tumor characteristics before and during surgery, management of solid adnexal tumor by laparoscopic surgery becomes possible.

• #33 Serine/threonine kinase 11 (STK11) associated adnexal tumors: from biology to therapeutic impact | Human Genomics | Full Text

  https://humgenomics.biomedcentral.com/articles/10.1186/s40246-025-00741-w

  Therefore, focusing on adnexal tumors in PJS patients or those associated with STK11 mutation is of great clinical significance. […] The NCCN guidelines for the genetic management of OC do not recommend genetic testing for individuals under the age of 18 if the results would not impact clinical decisions. […] Therefore, gene sequencing may only be suitable for individuals with clinical characteristics of PJS at an early age (28 years) or with a clear family history. […] In general, some cases of STK11-associated gynecological tumors occur in infancy or childbearing ages and typically exhibit lower malignancy. […] Therefore, comprehensive staging surgery, radiotherapy, chemotherapy, targeted therapy, and other treatments for some malignant and aggressive OC and FTC should be carried out in strict accordance with NCCN guidelines, especially when combined with highly malignant tumors. […] For women with STK11 mutations who have completed childbearing, relevant studies are exploratory and require the accumulation of more clinical cases.

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