title: Clinical management of incidental findings on pelvic adnexal masses.
abstract: Due to widespread use of pelvic and transvaginal ultrasound in routine gynecological evaluation, the incidental finding of adnexal masses has led to discussions about management in asymptomatic patients regarding the risk of ovarian cancer. Transvaginal ultrasonography remains the modality of choice in the evaluation of suspicious characteristics. The combined analysis of ultrasound morphological parameters with Doppler study, serum carcinoma antigen 125 and investigation of a symptom index may improve diagnosis. Surgical approach should be considered whenever there are suspicious images, rapid growth of cysts, changes in the appearance compared to the initial evaluation or when the patient has symptoms. Future studies on genetic and molecular mechanisms may help explain the pathophysiology of ovarian cancer, improving early diagnosis and treatment.
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Daniel Spadoto
authors.initials: DS
authors.lastname: Dias
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Flávia Neves
authors.initials: FN
authors.lastname: Bueloni-Dias
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Armando
authors.initials: A
authors.lastname: Delmanto
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Ângela Favorito Santarém
authors.initials: ÂF
authors.lastname: Tonon
authors.affiliation: Gynecology Service, Division of Pelvic Oncogynecology, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil.
authors.forename: Najla Mohamad
authors.initials: NM
authors.lastname: Tayfour
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Traiman
authors.affiliation: Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Dias
mesh_terms: D000291:Adnexal Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D058070:Asymptomatic Diseases; D000077216:Carcinoma, Ovarian Epithelial; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D033162:Incidental Findings; D009375:Neoplasms, Glandular and Epithelial / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010048:Ovarian Cysts / Q000145:classification / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018570:Risk Assessment; D014463:Ultrasonography