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Pelvic masses and endoscopic surgery: diagnosis
1Department of Obstetrics and Gynaecology, Hospital Universitari de Tarragona Joan XXIII, Spain.
Summary
Preoperative evaluation for adnexal masses is crucial to rule out cancer. Ultrasonography, tumor markers, and laparoscopic inspection guide management, with most benign cysts treated endoscopically.
Area of Science:
- Gynecologic Oncology
- Diagnostic Imaging
- Surgical Endoscopy
Background:
- Adnexal masses are common, with most being benign.
- Malignancy must be excluded through thorough preoperative assessment.
- Pelvic examination has limited diagnostic value for adnexal masses.
Purpose of the Study:
- To outline the diagnostic and management strategy for adnexal masses.
- To emphasize the importance of preoperative evaluation in excluding malignancy.
- To highlight minimally invasive treatment options for benign conditions.
Main Methods:
- Utilizing ultrasonography as a primary imaging modality.
- Employing tumor marker assays for risk stratification.
- Performing laparoscopic inspection for definitive evaluation when indicated.
- Considering laparotomy for suspected malignancy.
- Treating benign adnexal cysts with operative endoscopy.
Main Results:
- Ultrasonography and tumor markers are key diagnostic tools.
- Laparoscopic inspection is the final step to exclude malignancy.
- Laparotomy is reserved for confirmed or highly suspected malignancy.
- Operative endoscopy is effective for the majority of benign adnexal cysts.
Conclusions:
- A systematic preoperative evaluation is essential for adnexal masses.
- Imaging and tumor markers guide the diagnostic pathway.
- Minimally invasive approaches, including operative endoscopy, are preferred for benign adnexal cysts.