Prediction of Benignity of Solid Adnexal Masses

SST07-09

Prediction of Benignity of Solid Adnexal Masses

Scientific Formal (Paper) Presentations

Presented on December 3, 2010
Presented as part of SST07: Genitourinary (Benign Gynecologic Conditions and Pregnancy)

Shengfu Wang MD, Presenter: Nothing to Disclose

Samuel C. Johnson MD, Abstract Co-Author: Nothing to Disclose

To identify the sonographic features of benign solid ovarian tumors and to determine whether these tumors may be managed conservatively.

Sixty-three patients from September 1999 to September 2008 with solid adnexal masses with no or minimal cystic component or Doppler vascularity and acoustic attenuation were retrospectively reviewed. Twenty patients without pathology results or follow-up studies were excluded. The remaining 43 patients had follow-up imaging studies and/or surgical treatment. The median age of the study group was 52 years (range, 16–80 years).

Twenty-nine patients with solid adnexal masses were managed nonsurgically. Their age range was 26–80 years (median, 56). The size of the masses ranged from 0.7 to 8.3 cm (median, 2.2). The follow-up time ranged from 3 to 76 months (median, 30). Nineteen masses (65.5%) showed no change on the follow-up exam. Two masses showed an increase in size (6.9%), and eight masses (27.6%) showed a decrease in size or complete resolution. These masses all had well-circumscribed margins, were homogeneous, with increased attenuation, and had no or minimal vascular flow or cystic component. Normal ovarian tissue was detected in all of the masses. These patients exhibited no subsequent evidence of malignancy such as development of metastases, local invasion, or ascites. Fourteen patients with solid adnexal masses underwent surgical treatment. Their age range was 16–72 years (median, 40). The size of the excised masses ranged from 1.8 to 12.3 cm (median, 3.2). Normal ovarian tissue was sonographically demonstrated in only four of these masses (29%). All 14 patients (100%) had benign results at pathology. Four patients showed no ovarian neoplasm. Ten patients had benign ovarian neoplasms, including four fibromas, three fibrothecomas, one Brenner’s tumor, one granulosa cell tumor, and one teratoma.

We present a retrospective study of both surgical and nonsurgical management of solid ovarian masses. None of the sonographically diagnosed benign-appearing solid adnexal masses were subsequently proved to be malignant either at pathology or by clinical course.