The postmenopausal cystic adnexal mass: The potential role of ultrasound in conservative management

Goldstein, S. R.; Subramanyam, BR; Snyder, JR; Beller, U.; Bn, Raghavendra; Beckman, E.Mark

doi:10.1016/0020-7292(89)90878-3

Cited by 49 publications

(52 citation statements)

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“…8 However, when a further attempt at the differentiation between the ovarian carcinoma and borderline ovarian tumor is made, a significant rate of errors is to be expected. Several systems of morphologic evaluation of ovarian tumors have been proposed for sonography.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Ovarian Cancers From Borderline Ovarian Tumors on the Basis of Evaluation of Tumor Vascularity in Multi–Row Detector Computed Tomography—Comparison With Histopathology

Grabowska-Derlatka¹,

Derlatka

Palczewski³

et al. 2013

Int J Gynecol Cancer

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Morphological evaluation of tumor vascularity in MDCT seems to be an efficient method of differentiating between borderline ovarian tumors and ovarian carcinomas. Because of a small number of cases in the current study, a further research seems justified to confirm our results. The presented MDCT-angiographic criteria showed high sensitivity (97%) and specificity (96%) in differentiation of borderline ovarian tumors and ovarian cancers as compared with pathology. The presented CT-angiographic criteria of malignancy showed an excellent interobserver agreement.

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Section: Discussionmentioning

confidence: 99%

Differentiation of Ovarian Cancers From Borderline Ovarian Tumors on the Basis of Evaluation of Tumor Vascularity in Multi–Row Detector Computed Tomography—Comparison With Histopathology

Grabowska-Derlatka¹,

Derlatka

Palczewski³

et al. 2013

Int J Gynecol Cancer

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“…The inclusion criteria for a woman to be enrolled in the study group were as follows: (1) sonographic appearance of simple ovarian cyst (i.e., no septations, smooth capsule, absence of solid components), (2) persistent cyst on two sonographic examinations performed 3 months apart, and (3) pain generated by the cyst mandating immediate intervention. The median age was 39 years (range, 13 to 65 years); 76 women were premenopausal and 31 poshnenopausal.…”

Section: Methodsmentioning

confidence: 99%

Sonographically guided aspiration of ovarian cyst with simple appearance.

Caspi

Goldchmit²,

Zalel³

et al. 1996

Journal of Ultrasound in Medicine

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The objective of this study was to evaluate the role of sonographically guided aspiration of simple ovarian cysts. During the period from 1985 through 1992, 107 ultrasonographically guided punctures of apparently simple ovarian cysts were performed. The group included 76 premenopausal and 31 postmenopausal women who were followed for 1 to 6 years (mean, 2.7 years) after initial cyst puncture. In 42 cases, cyst aspiration constituted the definitive therapy. In 65 cases the cyst recurred and in this group, 38 women (with complete recurrence) were T he management of apparently simple ovarian cysts diagnosed by ultrasonography is still controversial. Conservative management, ultrasonographically or laparoscopically guided aspiration, and operation have been proposed. Pinotti and coworkersl found that 68.9% of 245 ovarian cysts less than 8 cm in diameter invo-ABBREVIATIONS IVF, In vitro fcrtiliz.1tionReceived February 7, 1995, from the Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel (affiliated to the Hebrew University School of Medicine and Hadassa, Jerusalem). Revised manuscript accepted for publication January 7, 1996. Address correspondence and reprint requests to Reinaldo Goldchmit, MO, Department of Obstetrics and Gynecology, Kaplan Hospital, 76100 Rehovot, Israel. operated on whereas 27 women with a cyst less than 5 cm (incomplete recurrence) were allocated to a follow-up group. Overall, in 69 cases (65%) surgery was avoided. No major complications were encountered. In our experience, aspiration of simple ovarian cysts is a suitable alternative in the management of this problem. Close follow-up is necessary to detect recurrence and perform surgical intervention when indicated. KEY WORDS: Ultrasonographically guided puncture; Cysts, aspiration; Ovary, cysts. luted spontaneously. Even in postmenopausal women with unilocular cyst (less or equal to 5 cm) the prevalence of malignancy is low2 and Goldstein and colleagues3 suggested serial sonographic followup scans as a possible way to manage these cases. However, ovarian cancer is still the leading cause of death from gynecologic malignancy, and some kind of diagnostic and therapeutic surgical intervention is necessary.Ovarian cysts occur mainly in young women, and most are functional cysts. To avoid unnecessary procedures that may affect future fertility in young women, conservative management, including aspiration cytology and follow-up of the patients, has been proposed. Fine needle aspiration cytology by laparoscopy4 or by ultrasonography5,6 is advocated by some authors. Cytologic analysis alone has its limitations7 and, therefore, the detection of recurrence by close follow-up is a sine qua non. We describe a study of 107 women who underwent sonographically guided aspiration of apparently simple ovarian cysts and long-term follow-up.

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“…The sonographic identification of a simple cystic mass indicates a benign process in 100% of premenopausal women and in 95% of postmenopausal women [11]. Even in postmenopausal women, cysts are identified at a frequency of 17%, which usually disappear or stablilize but may enlarge in 11% of the cases [12].…”

Section: Analysis Of Ovarian Masses: Benign Vs Malignantmentioning

confidence: 98%

Ovarian cancer: the clinical role of US, CT, and MRI

Togashi

2003

Eur Radiol

115

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This article presents an overview of ovarian cancer, which addresses the clinical roles of imaging studies, including US, CT, and MR imaging in the course of diagnosis and treatment of this important disease. US is the modality of choice in the evaluation of patients with suspected adnexal masses. Although its accuracy is not sufficient to avert surgery, morphological analysis of adnexal masses with US helps narrow the differential diagnosis, determining the degree of suspicion for malignancy, usually in concert with a serum CA-125 level. Combined morphological and vascular imaging obtained by US appear to further improve the preoperative assessment of adnexal masses. For uncertain or problematic cases, MR imaging helps to distinguish benign from malignant, with an overall accuracy for the diagnosis of malignancy of 93%. The accuracy of MR imaging in the confident diagnosis of mature cystic teratoma, endometrial cysts, and leiomayomas is very high. CT is not indicated for differential diagnosis of adnexal masses because of poor soft tissue discrimination, except for fatty tissue and for calcification, and the disadvantages of irradiation. In the staging of ovarian cancer, CT, US, and MR imaging all have a similarly high accuracy. Although it is difficult to suggest a simple algorithm for evaluating the state of women with adnexal masses, the correct preoperative diagnosis and staging of ovarian cancer with the use of any of these imaging studies will lead to an appropriate referral to a specialist in gynecologic oncology and offer a significant survival advantage for patients with ovarian cancer.

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The postmenopausal cystic adnexal mass: The potential role of ultrasound in conservative management

Cited by 49 publications

References 0 publications

Differentiation of Ovarian Cancers From Borderline Ovarian Tumors on the Basis of Evaluation of Tumor Vascularity in Multi–Row Detector Computed Tomography—Comparison With Histopathology

Differentiation of Ovarian Cancers From Borderline Ovarian Tumors on the Basis of Evaluation of Tumor Vascularity in Multi–Row Detector Computed Tomography—Comparison With Histopathology

Sonographically guided aspiration of ovarian cyst with simple appearance.

Ovarian cancer: the clinical role of US, CT, and MRI

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