Managing adnexal masses: a medical quandary

Management of Adnexal masses poses a double edged problem. There is a dilemma of performing extensive surgery in the form of staging laparotomy for a benign disease on one hand and the lurking fear of missing the diagnosis of malignancy on the other. Thus, it seems that it is important to establish risk profiles of all patients with adnexal masses so that they can reap the benefit of minimally invasive surgery wherever possible and be rightly subjected to staging laparotomy where indicated.

This prospective study was carried out at a Tertiary care Hospital. 136 women with an adnexal mass on ultrasound which met the said criteria were enrolled into the study from January 2008 to July 2011. They were then taken up for laparoscopic management.

All but 2 cases were found to be benign (134/136) after the final histopathology report using the said criteria.

Hence, by using simple readily available investigations like ultrasound (pattern recognition approach, Tumour morphology and ascites) and CA-125, the nature of adnexal mass can be reliably predicted and these patients can be safely offered the benefits of laparoscopic surgery.