Low Risk of Malignancy for Small Complex Adnexal Masses
(HealthDay News) — For older women with small complex adnexal masses, the overall risk of malignancy is low, according to a study published in the December issue of the American Journal of Obstetrics & Gynecology.
Elizabeth Suh-Burgmann, MD, from the Permanente Medical Group in Walnut Creek, CA, and colleagues examined outcomes for a large population-based cohort of women ≥50 years with a small (1–6cm) complex adnexal mass reported on ultrasound. The authors reviewed previous or subsequent pelvic ultrasounds to determine when the mass was first identified and whether there was a change over time. They excluded women with concurrent elevated CA125, evidence of metastatic disease, or <24 months of clinical follow-up.
The researchers identified 18 cancers or borderline tumors among 1,363 complex masses (1.3%). Among 204 women who had immediate surgery after initial ultrasound (15%), six cases were diagnosed; 12 additional cases were identified among 994 women who had at least one repeat ultrasound (73%). For all borderline and epithelial ovarian cancers, growth was apparent on ultrasound by seven months. Ten of the 12 cases diagnosed during follow-up were found to be stage 1 at surgery.
"Among isolated adnexal masses reported as complex and 1–6cm on pelvic ultrasound in women >50 years, the overall risk of malignancy is low," the authors write.