Management of the adnexal mass in pregnancy

Goh, William; Bohrer, Justin; Žalud, Ivica

doi:10.1097/gco.0000000000000048

Cited by 51 publications

(43 citation statements)

References 28 publications

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“…However, massively elevated CA125 levels (1,000-10,000 U̸ml) during the second trimester may mislead the gynecologist to suspect malignancy (8). In our study, the CA125 levels were increased above normal levels in all 4 cases.…”

Section: Discussionsupporting

confidence: 53%

Benign pelvic masses masquerading as adnexal cancer during pregnancy on ultrasound: A retrospective study of 5 years

Xie

Zhang

Wang

et al. 2015

Molecular and Clinical Oncology

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Abstract. This study was conducted to investigate the sonographic characteristics of benign adnexal masses misdiagnosed as malignancy, and determine whether sonographic findings may help distinguish these lesions from malignant tumors during pregnancy at a single center. We herein present our experience with pregnant women with benign adnexal masses misdiagnosed as malignancy by ultrasound and operated on during pregnancy or after delivery. A total of 4 cases of benign pelvic masses were misdiagnosed as adnexal cancer over a 5-year period, including an ovarian theca cell tumor with luteinization, an obsolete ectopic pregnancy of fallopian tube, an ovarian mature teratoma with abundant nervous tissue and a uterine myoma with degeneration. The masses were characterized by abundant blood flow and heterogeneous echo on ultrasound. In conclusion, adnexal masses identified during pregnancy exhibiting abundant blood flow and heterogeneous echo may not represent malignancy, even in the presence of increased carbohydrate antigen 125 levels. In certain cases, benign adnexal masses may be initially misdiagnosed as malignant during pregnancy.

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Section: Discussionsupporting

confidence: 53%

Benign pelvic masses masquerading as adnexal cancer during pregnancy on ultrasound: A retrospective study of 5 years

Xie

Zhang

Wang

et al. 2015

Molecular and Clinical Oncology

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“…When patients are diagnosed with pelvic masses, the first and most important thing is to determine the origin of the masses and then to evaluate whether they are benign or malignant. Although the majority of the pelvic mass was diagnosed with benign disease, 5–10% was diagnosed with an ovarian cancer, which is the fifth most common cause of cancer death in women worldwide [3–5]. As mortality was related to disease stage closely, an early diagnosis plays a vital role in determining a timely surgical and/or chemotherapeutic treatment [6].…”

Section: Introductionmentioning

confidence: 99%

Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses

Zhang

et al. 2016

Computational and Mathematical Methods in Medicine

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Purpose. The current study aimed to evaluate whether combined application of ultrasound and CT had increased Diagnostic Value in Female Patients with Pelvic Masses over either method alone. Patients and Methods. 240 female patients with pelvic masses were detected preoperatively with ultrasound and CT prior to surgery. The sensitivity, specificity, and accuracy of ultrasound, CT, and combined ultrasound/CT application were evaluated, respectively. Results. The sensitivity, specificity, and accuracy of ultrasound were 52.8%, 86.7%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of CT were 80.3%, 90.3%, and 85%, respectively. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were 89%, 94.7%, and 91.7%. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were higher than those of either ultrasound or CT. Conclusions. The combined application of ultrasound and CT had higher Diagnostic Value in Female Patients with Pelvic Masses than either method alone.

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“…Unexplained pain in late pregnancy should raise suspicion of adnexal torsion, even with normal adnexa at ultrasonography. Laparoscopic approach can be an option, although in a late pregnancy or in case of large uterus as in twin pregnancy laparotomic approach could be safer and faster . Whenever is possible a conservative surgery (detorsion with or without oophoropexy), should be performed, while salpingo‐oophorectomy has to be considered in case of necrosis.…”

Section: Discussionmentioning

confidence: 99%

Adnexal torsion with normal ovary in the third trimester of a twin pregnancy: Case report and literature review

Ferrari

Tisi

Forte

et al. 2018

J of Obstet and Gynaecol

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Management of adnexal torsion in a dichorionic diamniotic pregnancy at 32 weeks is presented. Adnexal torsion is a rare condition in pregnancy, particularly during late third trimester and with normal ovary and tube. The size of a twin uterus at late third trimester prevented a laparoscopic approach. A longitudinal laparotomic incision below the umbilicus permitted detorsion and fixation of the adnexa. To our knowledge, this is the first case reported in a late twin pregnancy.

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Management of the adnexal mass in pregnancy

Abstract: Most adnexal masses are benign and ultrasound characteristics can help guide the assessment of asymptomatic ovarian masses. When surgical management is chosen, laparoscopy can be safely performed in pregnancy. Ovarian torsion is a complication for persistent masses in pregnancy.

Cited by 51 publications

References 28 publications

Benign pelvic masses masquerading as adnexal cancer during pregnancy on ultrasound: A retrospective study of 5 years

Benign pelvic masses masquerading as adnexal cancer during pregnancy on ultrasound: A retrospective study of 5 years

Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses

Adnexal torsion with normal ovary in the third trimester of a twin pregnancy: Case report and literature review

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