Should colonoscopy screening be performed in patients with adnexal mass?

Abstract

Aim: Besides primary ovarian tumor, a part of adnexal masses are metastatic colorectal cancers (CRC). Additionally, the risk of CRC is increased if the genitourinary cancers are present. In this study, we want to examine the separation of primer ovarian tumor and colorectal tumor metastasis and we investigated whether the routine colonoscopy is necessary in patients with adnexal mass. Material and Methods: This study included 58 women who underwent colonoscopy due to adnexal mass (Group 1) and 438 women who underwent colonoscopy for other reasons (Group 2). The colonoscopy results compared retrospectively in both groups between March 2014 and June 2016 at Harran University, Faculty of Medicine. Results: DThe mean age were 46.18 ± 16.89 (range 20-84) and 48.72± 17.95 (range 20-94) years in group 1 and 2, respectively. CRC was seen in two women (3.4%) and polyp in five (8.6%) in group 1. However, CRC was detected in 22 women (5%) and polyp in 71 (16.3) in group 2. The incidences of CRC and polyp were found to be lower in women with adnexal mass than group 2. Conclusions: The incidences of CRC and polyp were found to be lower in women with adnexal mass than those of without adnexal mass. Nevertheless, routine colonoscopy screening should be considered for women with adnexal mass due to the difficulties in the discrimination of primary and metastatic ovarian cancer in preoperative period.

The Importance of Lower Gastrointestinal Tract Endoscopy Regarding the Preoperative Evaluation of Malignant Adnexal Masses

“…These results are consistent with studies of other researchers (8)(9)(10)12) Recent scientific findings suggest that when mechanical bowel preparation (MBP) (with or without antibiotics) is performed before the resection of left colon and rectum, there is a reduction in the rate of surgical site infection, anastomosis leakage and necessity for a diverting stoma and therefore MBP is recommended (13)(14)(15).…”

“…58.8 % of metastatic ovarian malignancies can be correctly diagnosed with intraoperative frozen section pathological examination. However, the distinction is more difficult for the cases of poorly differentiated serous carcinoma (10,11). Poorly differentiated serous carcinomas constitute half of the cases that had undergone bowel resection.…”