Does size matter? Retrospective analysis of large gynecologic tumors

Abstract

Objective:To evaluate the characteristics of patients who underwent surgery due to the presence of a large pelvic-abdominal mass over a 5-year period in a university clinic.Material and Methods:Among 3476 gynecologic operations, intraoperative findings were evaluated retrospectively. Uterine and/or adnexal masses smaller than 20 cm were excluded to refine “large” tumors and 74 patients with large tumors were enrolled in the study group. Demographic characteristics, intraoperative findings, and results of histopathologic examinations were recorded. Moreover, preoperative and intraoperative findings were compared among tumors with adnexal origin according to their final histopathologic results.Results:The mean age of the patients was 46 years. The most common symptom was abdominal pain, as recorded in 38 (51.4%) patients. Among all patients, 31 (41.9%) had coexisting illness and 13 (17.6%) had a history of surgery. The mean tumor diameter was 25.9±8.6 cm (20-60) and 60 (78.9%) tumors were of adnexal origin. The ratios of malignancy for large adnexal and uterine tumors were 34.4% and 12.5%, respectively. When the large adnexal tumors were re-evaluated, the mean cancer antigen (CA) 125 level was significantly higher, and ascites was more frequently detected in malignant tumors (p<0.01) then in benign and borderline tumors.Conclusion:Benign and borderline tumors are more common among large abdominopelvic masses, although the presence of ascites and elevated CA 125 may present malignancy in large gynecologic tumors. Further studies with larger sample sizes are needed to define the characteristics of large tumors and their malignant potentials.

Laparoscopic Management of Large Adnexal Masses

“…One of the important factors against the suggestion of laparoscopic surgery for large adnexal masses is the risk of rupture and its negative effect on patients' outcomes (7,8). However, in our study, incidental rupture was only observed in 8 patients, two of whom were malignant.…”

“…Another important factor for the choice of laparoscopic or laparotomic management of adnexal masses is the size of the mass, and due to the technical di culty of performing laparoscopy, limited surgical eld, and the higher probability of malignant potential in adnexal masses, some suggest the use of laparotomy in large adnexal masses (7,8).…”

Laparoscopic management of massive recurrent endometrioma with atypical presentation: A case report

“…Even the ultrasound report was that of a likely mucinous cystadenoma, which are usually large and benign. It has been noted in the literature that benign and borderline tumours are more common among large abdominopelvic masses, although the presence of ascites and elevated CA 125 may present malignancy in large gynaecologic tumours, 6 which were not seen in our case.…”

Removal of Massive Ovarian Tumor Weighing 35.4 kg in a Tertiary Care Hospital: A Case Report

“…Imaging and calculating RMI is a massive ovarian tumor is another difficult work due to poor visibility of adjacent intra-abdominal organs and only the mass can be visualized. 5 However, consistency and septation can be evaluated well, though the size and origin may often be disguised. Computed tomography scan may be superior for evaluating the status of the retroperitoneal lymph nodes only.…”