[Echographic evaluation of the integrity of adnexa tumors]

The preoperative diagnosis of pelvic tumours is getting more and more important. This has special relevance to the increasing possibilities of conservative management of adnexal tumours and cysts (puncturing or operating by laparoscopy). We reviewed sonographical and histological data of 514 patients, who were operated on in the 2nd Department of Obstetrics and Gynaecology in Vienna because of pelvic masses. We correlated sonographical parameters like size of tumour, distinctness of margins, different kinds of internal echo pattern, papillary vegetation on the cystic wall or septa, with the defined histopathological diagnosis. A close relationship between size of tumour and tumour status could be found. The size of benign tumours was 7.1 cm. Malignant tumours had a size of 10.7 cm. The size of the high-echogenic area within the tumour, as well as its homogeneity, seemed to be of great importance. Such tumours with high-echogenic areas within, and especially those who had nonhomogeneous structures of these areas, proved to be malignant in 81% of the cases. Similarly, we found a close correlation of papillary vegetation either on cystic walls or on septa with the confirmed diagnosis of malignancy. Septa without papillarities or changing of their thickness were less important. By means of using our criteria a less experienced sonographic examiner could reach as good results as an experienced one in predicting malignancy.