Current diagnostic approach to patients with adnexal masses: which tools are relevant in routine praxis?
OBJECTIVE
The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist.


METHODS
Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index (PDI), risk of malignancy index (RMI) and body mass index (BMI) were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed.


RESULTS
The study included 689 women (112 malignant, 544 benignant, and 33 borderline tumors). Malignant and borderline tumors were more frequent in postmenopausal women (P=0.000). Women who had benignant tumors had the lowest BMI (P=0.000). There were significant (P<0.05) differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen (CEA) levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors (P=0.000). Women with malignant tumors had highest values of RMI and PDI (P=0.000).


CONCLUSIONS
Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors.
Clinic of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade 11000, Serbia; ; School of Medicine, University of Belgrade, Belgrade 11000, Serbia;
Milan M
MM
Terzic
Jelena
J
Dotlic
Ivana
I
Likic
Nebojsa
N
Ladjevic
Natasa
N
Brndusic
Nebojsa
N
Arsenovic
Sanja
S
Maricic
Tihomir
T
Mihailovic
Sasa
S
Andrijasevic
Adnexal mass; body mass index; power Doppler index; risk of malignancy index; tumor markers