Practical Recommendations for the Management of Benign Adnexal Masses

Rocha, Rodrigo; Barcelos, Ionara Diniz Evangelista Santos

doi:10.1055/s-0040-1714049

Cited by 3 publications

(2 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of ovarian cancer is lower than breast cancer, but it is three times more lethal, and the mortality rate caused by ovarian cancer in 2040 is predicted to increase signifi cantly. [1][2][3] Tumour marker is a vital component of early diagnosis in several types of malignancy. The Carbohydrate Antigen 125 (CA 125) is one of the widely used tumour markers; it increases in some physiological and pathological conditions, such as menstruation, pregnancy, endometriosis, and peritoneal infl ammatory disease.…”

Section: Introductionmentioning

confidence: 99%

Roma Index and Adnex Model: which is more Superior in Predicting Epithelial Ovarian Malignancy?

Lumandung,

Suzanna P. Mongan,

Bismarck J. Laihad

2023

Indones J Obstet Gynecol

View full text Add to dashboard Cite

Objective: To compare the accuracy of ROMA index andADNEX model in predicting the risk of malignancy in ovariantumour.Methods: This was a prospective analytic study. A total of 37samples were acquired from women of all ages diagnosedwith an ovarian cystic tumour in the Central General HospitalProf. Dr. R. D. Kandou. A CA-125 marker, HE4 marker,menopausal status and ultrasonography (USG) examinationwere obtained, and subsequently compared with the fi nalhistopathological results. The data were analysed by usingthe SPSS statistics software.Results: Thirty-seven women participated in this study. Themean age of participants was 43 years old. The Area UnderCurve (AUC) of the ADNEX was 0.979 with a sensitivity of90.0%, specifi city of 88.2%, negative predictive value of89.8%, and positive predictive value of 80.5%. The AUC ofthe ROMA model was 0.734 with the sensitivity, specifi city,negative predictive value, and positive predictive value of65.0%, 64.7%, 64.8%, and 64.8%, respectively. Both modelsshowed AUC values > 0.50 (p-value < 0.05).Conclusions: The IOTA ADNEX had better accuracy than theROMA model in predicting ovarian epithelial malignancy.The ADNEX model had higher sensitivity and specifi city thanthe ROMA model.Keywords: ADNEX, CA-125, HE4, Ovarian tumour, ROMAAbstrakTujuan: Untuk membandingkan akurasi indeks ROMAdan ADNEX model dalam memprediksi keganasan tumorovariumMetode: Penelitian ini merupakan studi analitik prospektif.Total 37 sampel penelitian didapatkan dari wanita yangdidiagnosa tumor ovarium kistik di RSUP Prof. Dr. R. D.Kandou. CA-125, HE4, status menopause dan pemeriksaanUSG dilakukan, dan dibandingkan dengan hasil histopatologi.Data kemudian dianalisa menggunakan program statistikSPSS.Hasil: Tiga puluh tujuh perempuan yang berpartisipasidalam penelitian ini. Dengan rerata usia 43 tahun. TotalArea Under Curve (AUC) dari IOTA ADNEX adalah 0,979dengan sensitivitas 90,0%, spesifi sitas 88,2%, nilai prediksinegatif 89,8%, dan nilai prediksi positif 80,5%. AUC darimodel ROMA adalah 0,734 dengan sensitivitas, spesifi sitas,nilai prediktif negatif dan nilai predikitif positif 65.0%, 64.7%,64.8%, dan 64.8% berturut-turut. Kedua model menunjukkannilai AUC > 0,50 (nilai p <0,05).Kesimpulan: IOTA ADNEX memiliki akurasi yang lebih baikdibandingkan model ROMA dalam memprediksi keganasanovarium epithelial. ADNEX model memiliki sensitivitas danspesifi sitas lebih tinggi dibandingkan model ROMAKata kunci: ADNEX, CA-125, HE4, ROMA, Tumor Ovarium.

show abstract

Section: Introductionmentioning

confidence: 99%

Roma Index and Adnex Model: which is more Superior in Predicting Epithelial Ovarian Malignancy?

Lumandung,

Suzanna P. Mongan,

Bismarck J. Laihad

2023

Indones J Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…The number of women having adnexal masses has increased markedly due to the extensive use of ultrasonography, and as a result of the low malignancy possibility of these masses, a lot of ultrasound signs were defined to follow up these patients without the need for surgical interventions due to low malignancy potential. It is estimated that 5-10% of women in The US will submitted to a surgical intervention for a suspected ovarian cancer during their lifetime, and 13-21% of these women will be found to have a malignant ovarian neoplasm [6,19] .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Calculated Risk of Malignancy Index as a Predictor of the Nature of Adnexal Masses

Mostafa

Assem

Ibrahim

2022

International Journal of Medical Arts

View full text Add to dashboard Cite

Article informationBackground: Adnexal masses are common presentation among gynecological practice. Differentiation of benign than malignant lesions is of utmost importance for treatment plan. The gold standard other than histopathology did not determined yet. The aim of the work: The current work aimed to measure the predictive power of the preoperative risk of malignancy index [RMI] to discriminate between benign and malignant adnexal masses. Patients and Methods: This study included 80 patients, presented with adnexal masses/ovarian cysts. They were managed by surgery, during the period from May 2015 to November 2017. We collected the following data: age, gravidity, menopause status, parity, cancer antigen 125 [CA125] levels and ultrasound results. RMI was calculated according to Tingulstad" model. Postoperatively, histopathology results were documented for every patient and used as the gold standard diagnostic modality to measure predictive power of RMI and CA125. Results: Malignant lesions were documented in 27.5%, while 72.5% were benign. The benign tumors were significantly associated with younger age than malignant lesions [27.88±7.68 versus 41.05±11.81]. The postmenopausal women percentages were significantly higher among malignant than benign ovarian lesions [45.5% vs. 1.7%, respectively, p < 0.001]. All ultrasound parameters of RMI were significantly different in malignant than benign masses. The optimal cutoff points of RMI and CA125 were 90.6 and 20.0 respectively. At such points, RMI had 90.6 sensitivity. However, specificity, positive predictive value, negative predictive values were 68.2%, 75.9%, 51.7% and 86.3%, respectively. Conclusion: RMI represented a significant indicator in preoperative assessment of adnexal mass, and was valuable to refer patients to oncology centers, and recommended for screening purposes.

show abstract

Adnexal torsion in girls: Predictors and methods for surgical treatment. Case reports and review

Donskoy,

Korovin,

Vilesov

et al. 2024

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

View full text Add to dashboard Cite

Modern diagnostic and treatment methods make it possible to establish a preoperative diagnosis of uterine torsion and provide surgical assistance. Thus, the causes of this disease and the scope of surgical treatment must be investigated. This study reports the cases of 20 patients aged 3–17 years with uterine torsion who were treated at the St. Vladimir Children’s City Clinical Hospital between 2017 and 2023. Ultrasonography is a mandatory preoperative screening diagnostic method. All patients underwent laparoscopic surgery. During the postoperative period, magnetic resonance imaging was performed to confirm the diagnosis. Increased ovarian size due to cysts (7), paramesonephric cysts (4), and fixed lateroflexion (6) were identified as predictors of torsion. In 3 (15%) patients, the cause of torsion was unknown. Paramesonephric cysts were resected, and two adnexectomies were performed. After detorsion, 12 (60%) patients underwent fixation of the appendages. A literature search was conducted using PubMed, Scopus, eLibrary, and RSCI. A total of 47 articles were analyzed, 58 articles were reviewed, and 39 on the problems of determining predictors of uterine torsion in children and methods of surgical correction were selected. Based on the data obtained, the main disease predictors were clarified. A change in the angle of the uterus (lateroflexion) was found to cause the atypical location of the ovaries, which in turn can lead to torsion of the changed or unchanged appendage. Suggestions have been made regarding the connection between connective tissue dysplasia and uterine lateroflexion in the development of adnexal torsion in childhood. The results confirmed the complexity of the radiological diagnosis of lateroflexion. The scope of the surgical intervention for acute torsion of the uterine appendages was dependent on the etiology of the torsion and the degree of ischemia of the appendage. Various options for detorsion with unilateral and bilateral oophoropexy and without fixation of the injured appendage have been proposed. Removal of uncomplicated paramesonephric formations of the uterine appendages identified during diagnostic laparoscopy is a simple procedure and helps prevent torsion. Thus, puncture of accidentally detected ovarian cysts in patients who have not been examined for tumor markers is deemed inappropriate.

show abstract

Practical Recommendations for the Management of Benign Adnexal Masses

Cited by 3 publications

References 47 publications

Roma Index and Adnex Model: which is more Superior in Predicting Epithelial Ovarian Malignancy?

Roma Index and Adnex Model: which is more Superior in Predicting Epithelial Ovarian Malignancy?

Evaluation of the Calculated Risk of Malignancy Index as a Predictor of the Nature of Adnexal Masses

Adnexal torsion in girls: Predictors and methods for surgical treatment. Case reports and review

Contact Info

Product

Resources

About