Evaluation of ovarian tumors in postmenopausal women by transvaginal sonography

Osmers, R.; Osmers, M.; Maydell, Bernd von; Wagner, B; Kuhn, Walther

doi:10.1016/s0301-2115(97)00235-2

Cited by 27 publications

(17 citation statements)

References 40 publications

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“…Furthermore, other studies1, 7, 8, 28, 29 have reported that BOT can exhibit sonographic features such as unilocular smooth anechoic cysts without endophytic papillary growth. Gotlieb et al 8 reported 13% and Emoto et al 7 reported 17% of BOT with a sonographic appearance of unilocular cysts, while in a prospective study of 1072 premenopausal ovarian tumors, Osmers et al 28 demonstrated that malignancy occurred in 0.8% of unilocular smooth‐walled cysts, and that 0.5% of unilocular smooth‐walled cysts were BOT.…”

Section: Discussionmentioning

confidence: 94%

Preoperative sonographic features of borderline ovarian tumors

Exacoustòs

Romanini

Rinaldo

et al. 2004

Ultrasound in Obstet & Gyne

111

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Section: Discussionmentioning

confidence: 94%

Preoperative sonographic features of borderline ovarian tumors

Exacoustòs

Romanini

Rinaldo

et al. 2004

Ultrasound in Obstet & Gyne

111

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“…Of the remaining studies, limitations include the following: selection bias, most commonly for retrospective surgical cohorts in which the prevalence of malignancy is higher than clinical populations of women with adnexal masses (45,46), or screening trials that may not be generalizable to clinical populations (6,7,41); uncertainty if the sonographically identified simple cyst corresponds to the pathologically identified carcinoma; possible misclassification of simple cysts as a result of older imaging equipment or scanning protocols (28); and utilization of outdated pathologic terminology.…”

Section: Limitations Of Existing Literaturementioning

confidence: 99%

“…The studies in Table E3 (online) evaluated patients undergoing surgery who generally were already known to have persistent cysts. Despite the fact that these studies have a bias toward detecting a higher risk of malignancy than in the general population (30,47), the majority of these studies found a malignancy rate of 0% for simple cysts (with sample sizes of seven to 221 patients) (25,30,45,46,(48)(49)(50)(51)(52)(53)(54)(55). A meta-analysis (56) that included many of the studies in Table E3 (online) found 20 malignancies (including eight borderline tumors) among 2290 simple cysts removed surgically (0.9%; 95% confidence interval: 0.57%, 1.35%).…”

Section: Studies Based On Surgical Cohorts Overestimate Riskmentioning

confidence: 99%

Simple Adnexal Cysts: SRU Consensus Conference Update on Follow-up and Reporting

Levine¹,

Patel²,

Suh-Burgmann³

et al. 2019

Radiology

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T he Society of Radiologists in Ultrasound (SRU) convened a multidisciplinary consensus conference in 2009 to make recommendations for adnexal cyst follow-up. Our goal was to define characteristics of benign adnexal cysts to reduce surgical evaluation and imaging follow-up (1). Commensurate with the overall goal of the Choosing Wisely campaign to reduce unnecessary imaging (2), the consensus recommendations published in 2010 established size thresholds for benign-appearing cysts not requiring follow-up (Table E1 [online]). This effort was successful. One study (3) found that the guidelines reduced overall US utilization because of decreased radiologists' recommendations for follow-up of benign-appearing cysts, while another study (4) validated the guideline in mostly symptomatic women and suggested that the utility of the SRU framework was not limited to asymptomatic cysts. Recent large studies (5-7) showing no increased risk of malignancy in women with simple adnexal cysts irrespective of cyst size justify reevaluation of the 2010 SRU guidelines, specifically to address the follow-up and reporting of simple cysts. The consensus group met by teleconference from February through June 2019 under the auspices of the SRU, and consisted of 20 experts in US, gynecologic imaging, gynecologic pathology, gynecologic oncology, epidemiology, radiology, and minimally invasive surgery (Table E2 [online]). Before starting the phone discussions, three of the author group (D.L., M.D.P., D.L.B.) reviewed the literature in Tables E3 and E4 (online) (with each article having at least two reviewers) and made the summary information from the literature, along with reasons for exclusions of studies, available to the larger group. The pathology expert (J.H.) did not participate in votes regarding clinical recommendations. We used a modified Delphi model for discussion and voting cycles among experts. In this article, we use the term strong consensus when there was greater than or equal to 90% agreement among the 19 voting panelists (18 individuals), moderate consensus for recommendations based on greater than or equal to

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“…20 Other studies found that the risk of malignancy in simple cysts, defined as unilocular with smooth inner wall, rises from 0.8% in premenopausal women to 9.6% in postmenopausal women. 21,22 Bailey et al found in 7,705 asymptomatic postmenopausal women 256 unilocular cysts, all of which were < 10 cm in diameter, and 90% were < 5 cm and were associated with minimal risk for ovarian cancer. 23 Solid parts, semi-solid, and mixed tumors seem to be malignant in 2-17% in premenopausal and 66-74% in postmenopausal women.…”

Section: Preoperative Investigation Of Adnexal Massesmentioning

confidence: 99%

Laparoscopic Management of the Adnexal Mass

Pados

Tsolakidis

Bontis

2006

Annals of the New York Academy of Sciences

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In the past few years the contribution of operative laparoscopy in all fields of gynecological surgery has been revolutionary. Nowadays laparoscopic management of adnexal masses is the most frequently performed laparoscopic intervention. Laparoscopy in comparison to laparotomy has the advantages of lower morbidity, shorter length of hospital stay, decreased postoperative pain, lesser de novo adhesion formation, better cosmetic results, faster recovery, and reduced overall cost of care. However, careful preoperative evaluation is important for the appropriate and successful use of laparoscopy for removal of adnexal masses and the advantages of the laparoscopic approach should, in no way, compromise the clinical outcome in women with malignancy. Patient's age, history, findings of physical examination, and the results of serum markers in combination with the imaging assessment, such as Doppler sonography, CT, or MRI, should be considered to reach the diagnosis preoperatively. However, only pathology of the adnexal mass can provide the definitive diagnosis. The specific characteristics of the adnexal masses in childhood, adolescent, reproductive, and postmenopausal age represent the essential parameters that will determine the therapeutic strategy to be followed. Furthermore, the clinician has to determine whether an adnexal mass requires surgery or expectant management as well as to estimate the possibility of malignancy.

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Evaluation of ovarian tumors in postmenopausal women by transvaginal sonography

Cited by 27 publications

References 40 publications

Preoperative sonographic features of borderline ovarian tumors

Preoperative sonographic features of borderline ovarian tumors

Simple Adnexal Cysts: SRU Consensus Conference Update on Follow-up and Reporting

Laparoscopic Management of the Adnexal Mass

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