title: Risk of torsion and malignancy by adnexal mass size in pregnant women.
abstract: OBJECTIVE
  To investigate risks of torsion and malignancy by adnexal mass size during pregnancy.
  
  
  METHODS
  Retrospective review of medical records.
  
  
  METHODS
  General university hospital and healthcare center.
  
  
  METHODS
  Four hundred and seventy women who underwent surgery for adnexal masses during pregnancy between 2002 and 2009.
  
  
  METHODS
  Rate of torsion and malignancy according to mass size classified into four groups: <6, 6-10, 10-15 and ≥15 cm.
  
  
  RESULTS
  Torsion was encountered in 55 patients (11.7%) and malignancy was confirmed in 20 (4.3%). A mass size of 6-10 cm had a significantly higher risk of torsion than a mass <6 cm (odds ratio 2.68, 95% confidence interval 1.33-5.40, p=0.006). Masses ≥15 cm had an approximately 12-fold higher risk of malignancy compared with masses <6 cm (odds ratio 12.36, 95% confidence interval 2.90-52.67, p=0.001). However, for masses of 10-15 cm, the risks of both torsion and malignancy were not higher than those of masses <6 cm.
  
  
  CONCLUSIONS
  Risks of torsion and malignancy are not directly proportional to increasing mass size in pregnant women. Physicians should be aware of a high risk of malignancy in women with an adnexal mass of over 15 cm. However, if a mass is smaller, the size should not be considered as a single independent factor in a decision for surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Yu-Jin
authors.initials: YJ
authors.lastname: Koo
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Kim
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Lee
authors.forename: Yong-Soon
authors.initials: YS
authors.lastname: Kwon
authors.forename: Hyun-Ja
authors.initials: HJ
authors.lastname: Kim
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Lee
authors.forename: Kyung-Taek
authors.initials: KT
authors.lastname: Lim
authors.forename: Ki-Heon
authors.initials: KH
authors.lastname: Lee
authors.forename: Jae-Uk
authors.initials: JU
authors.lastname: Shim
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Mok
mesh_terms: D000291:Adnexal Diseases / Q000473:pathology* / Q000601:surgery; D000328:Adult; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies