Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ADNEXITIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed1998

[The observation of proliferative cell nuclear antigen and AgNORs in ocular adnexal lymphoid hyperplasia].

PURPOSE: To investigate the expression of proliferative cell nuclear antigen and Nuclear Organizer Region in ocular adnexal lymphoid hyperplasia and its histopathologic classification. METHOD: Using anti-proliferative cell nuclear antigen monoclonal antibody (PC10) and AgNORs method, the proliferative cell in 34 cases of ocular adnexal lymphoid neoplasms (benign lymphoid lesion, BLL, 14 cases; atypical lymphoid hyperplasias, AH, 9 cases; malignant lymphomas, ML, 11 cases) were detected in formalin fixed and paraffin-embeded tissue. RESULTS: A significant difference between BLL and AH, BLL and ML was observed (PCNA P < 0.001, P < 0.001; AgNORs P < 0.01, P < 0.001); similar result was observed between AH and ML in PCNA index (P < 0.01). But there was not a significant difference in AgNORs count (P > 0.05). The linear regression coefficient between PCNA index and AgNORs number was excellent (0.8693). CONCLUSION: The two methods may be helpful to distinguish ocular adnexal lymphoid reactive hyperplasia and malignant lymphoma.

Antigens, Nuclear↗
PubMed2003

A prospective study of the role of ultrasound in the management of adnexal masses in pregnancy.

OBJECTIVE: To assess the clinical relevance of adnexal masses in pregnancy and the usefulness of ultrasound in their management. DESIGN: A prospective study on pregnancy complicated by adnexal masses. SETTING: Department of Obstetrics and Gynaecology in Italy. POPULATION: 6636 women with pregnancy in utero followed in our clinic from January 1996 to December 1999. METHODS: From 1996 to 1999, all ovarian cysts with a diameter exceeding 3 cm were prospectively recorded and followed. The management was expectant except in case of symptoms or suspected malignant features. Cysts suggestive of borderline tumours were treated expectantly. MAIN OUTCOME MEASURES: Clinical relevance of adnexal masses in pregnancy, the outcome of these pregnancies and the usefulness of ultrasound examination in their management. RESULTS: We detected 82 cysts in 79 of 6636 women (1.2 in 100 term pregnancies). Sixty-eight women were asymptomatic at the time of diagnosis, whereas 11 (13.9%) were diagnosed because of pain. Diagnosis occurred in the first trimester for 57 cases and in the second or third trimester in 22 (27.8%). One-half of the cysts were simple and anechoic at ultrasound. Fifty-seven had a diameter not exceeding 5 cm. Forty-two cyst resolved in pregnancy without treatment. Three cysts required surgery within few days (torsion). One woman required laparotomy at the 37th week of gestation, due to torsion. When one case of termination was excluded, 78 women delivered at term (66 vaginally, 12 by caesarean section). Nineteen women underwent surgery after pregnancy. We recorded three Stage Ia borderline tumours, accounting for 3/82 cysts (3.6%) and 3/30 persisting masses (10%). CONCLUSION: Ultrasound allows definition of ovarian cysts in pregnancy and this positively impacts on management. The incidence of cancer among persistent masses is lower than previously reported. Acute complications in stable cysts are extremely uncommon after the first trimester. An expectant management is successful in the majority of cases and should be considered more often. Routine removal of persistent cysts is not justified.

Female↗
PubMed2003

A model for malignancy probability prediction of adnexal masses.

OBJECTIVE: To develop a model for pre-operative malignancy probability determination in a patient with an adnexal tumor or tumors by the application of multivariate logistic regression analysis to variables at the time of pelvic sonography. METHOD: Pre-operative ultrasound examination including Doppler analysis was performed on 117 consecutive women scheduled for surgery because of an adnexal mass or masses. Each tumor was classified as probably benign or malignant using a subjective evaluation system on the gray-scale morphological images. Then, Doppler sonography was carried out. The resistance index (RI) and pulsatility index (PI) of the vessel with the highest velocity were recorded. Multivariate logistic regression analysis was performed with the histological outcome as the dependent variable. Independent variables included patient's age, menopausal status, gray-scale morphological data, RI and PI. The probability of malignancy was formulated from statistical analysis. RESULTS: There were 117 women included in the study, 83 (71%) with histologically benign and 34 (29%) with histologically malignant ovarian tumors. Regression analysis on the five variables resulted in the retention of only patient's age, morphological data and RI as significant contributing factors for malignancy prediction. The probability of malignancy was 1/(1+e(-z)) where e was the base value for natural logarithms and z was the regression equation: -3.6355 + 1.8028 (age) + 2.1047 (morphological data) + 2.9816 (RI). CONCLUSION: A model for estimation of probability of malignancy for an adnexal tumor was derived using multivariate logistic regression analysis. The prediction should be more accurate than that from either gray-scale ultrasound imaging or Doppler velocimetry alone. The test of the model is now on-going.

Adult↗
PubMed1992

Recent advances and controversies concerning adnexal neoplasms.

This article reviews the diagnostic clinical and histologic features of a group of adnexal tumors, including papillary eccrine adenoma, adenoid cystic carcinoma, Merkel's cell carcinoma, aggressive digital papillary adenoma (and adenocarcinoma), Bowen's disease, intraepidermal epithelioma, microcystic adnexal carcinoma and related tumors, and subcutaneous trichoepithelioma. These are adnexal tumors either often not recognized, because of their rarity, or the origin, biologic potential, and classification of which have been controversial.

Adenocarcinoma, Papillary↗
PubMed2003

[Use of multilayer perception artificial neutral networks for the prediction of the probability of malignancy in adnexal tumors].

BACKGROUND: Advanced statistical methods are currently are more often used in the prediction of ovarian malignancy when adnexal tumor is detected. These methods include logistic regression analysis and artificial neural networks (ANN's), i.e. computer programs which are capable of learning from presented data and further predict various events, such as clinical diagnosis or outcome of a given treatment. MATERIALS AND METHODS: We have analyzed data of 307 women with adnexal tumors who were operated in the Ist Dept. of Gynecology, Medical University in Lublin between 2000-2002. Following clinical and sonographic variables were included: age, menopausal status, serum CA-125, bilaterality, tumor size and volume, papillary projections, septa, solid parts presence, Doppler blood flow indices (PI, RI, Vmax), and subjective-color Doppler score. A multiple layer perceptron (MLP) neural network with 13 input variables, 11 hidden neurons and one output variable was constructed to assess probability of malignancy in each women (Statistica v. 6.0 for Windows, Statsoft, USA). Sensitivity, specificity and accuracy of the model were calculated. Receiver-Operating Characteristics curves were generated and corresponding Areas Under ROC Curves (AUROC's) for all diagnostic tests were compared. RESULTS: Final histologic examination revealed 228 (74.3%) benign tumors and 79 (25.7%) malignant masses including 21 women with FIGO stage I ovarian cancer. With a 75% cut-off probability of malignancy level the sensitivity and specificity of the best network in the testing set was 96.7% and 100%, respectively. In the validation set the corresponding values of sensitivity and specificity were 82.3% and 97.5%. The highest of all used tests AUROC equal to 0.9749 was found for the ANN predictive model. CONCLUSIONS: ANN may help in the extraction of the most useful predictive clinical and ultrasound data. The sensitivity and specificity of the ANN's generated model were higher than currently used single clinical and diagnostic tests. However, a prospective testing in a new, much larger group of women with adnexal tumors is essential for the clinical usefulness of the proposed statistical model.

Adult↗
PubMed2004

Outcome and prognostic factors in ocular adnexal lymphoma.

AIM: To classify ocular lymphomas in patients treated at the Zagreb University Hospital Center according to the new classification of the World Health Organization (WHO) and to determine factors with prognostic significance. METHODS: From 1986 to 2003, histological diagnosis of ocular lymphoma was made in 24 patients. The median age of patients was 62 years, with 2:1 female predominance. The patients underwent staging procedures and clinical evaluations prior to the date of the initial therapy. Histopathologic slides were reviewed and tumors were classified according to the new WHO classification. Additional immunohistochemical studies were performed on 35 available specimens. The antibodies used were CD3, CD5, CD10, CD20, CD43, and bcl-6; and in a few cases cyclin D1, bcl-2, CD23, CD79a, and CD138. The main outcome measures were development of distant recurrence after new presentation with solely ocular adnexal disease, and death attributable to widespread lymphoma. RESULTS: Ocular adnexal lymphomas were found in orbit in 20 patients, in eyelid in two, and conjunctiva in two patients. Twenty patients had lymphoma stage IE, one had IIE, and three had stage IV. Three patients had prior or concurrent systemic disease and 21 patients had primary lymphoma. The main subtypes of non-Hodgkin lymphoma according to the WHO classification were extranodal marginal zone B-cell lymphoma (n=20), diffuse large cell B-cell lymphoma (n=2), mantle cell lymphoma (n=1), and plasmacytoma (n=1). Six lymphomas were CD43 positive and five of them were extranodal marginal zone B-cell lymphomas. Radiotherapy was given to 11 patients, chemotherapy in 8 patients, whereas radiotherapy and chemotherapy were implemented in three patients. Two patients underwent only surgical excision of the tumor. Local relapse was found in three and distant recurrence in four patients. Distant recurrence was found in four patients with stage IE (two of them also had a local relapse). In the group of patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (B-EMZL), the estimated 5-year overall survival was 92.9+/-6.6% (mean+/-standard deviation) and the 5-year failure-free survival was 80.1+/-10.3%. Age, sex, side of involvement, anatomic localization of the lesion, clinical stage of disease, and mode of therapy did not have any prognostic significance during the follow-up period (median, 53; range, 9-131 months). Immunohistochemical marker CD43 was the only parameter of prognostic significance (p=0.035). Patients with B-EMZL had almost 14 times higher chance for an unfavorable outcome if the tumor cells expressed CD43 on their surface, than the CD43-negative cases. CONCLUSION: Most ocular adnexal lymphomas usually have a B-cell immunophenotype, the morphologic and immunohistochemical features of extranodal marginal zone B-cell lymphoma, and a favorable prognosis. Our data suggest that CD43 could be useful to separate the group of patients with extranodal marginal zone B-cell lymphomas with unfavorable prognosis from those that have a good prognosis. CD43 positive ocular lymphomas are associated with a higher rate of subsequent distant recurrence and the rate of lymphoma-related death.

Adult↗
PubMed1992

Corticosteroids in the management of adnexal hemangiomas in infancy and childhood.

Adnexal hemangiomas are common in infancy and childhood. They can be interesting to the ophthalmologist for two reasons: cosmetic and functional (the second, the more important). By their natural history, they can produce serious visual consequences by producing refractive or stimulus-deprivation amblyopia. The management of adnexal hemangiomas is a challenge. The accepted method is most instances is corticosteroid therapy. This is administered either by local, intralesional, or systemic routes; the first is preferred. Steroid therapy can cause systemic and local side effects. Furthermore, a rebound effect can occur with this type of therapy. We present the cases of 12 patients with adnexal hemangiomas treated with steroids. These patients are reviewed, with emphasis on their responses and the complications of steroid therapy.

Betamethasone↗
PubMed2005

[Clinical and pathological features of 112 cases with ocular adnexal lymphoproliferative lesions].

OBJECTIVE: To investigate the histopathological classification and clinical features of ocular adnexal lymphoproliferative lesions. METHODS: The clinical, histomorphological and immuno-histochemical features of 112 cases of ocular adnexal lymphoproliferative lesions (116 paraffin specimens) were studied retrospectively. The lesions were classified according to the World Health Organization classification of tumors of haematopoietic and lymphoid tissues (2001). RESULTS: This group of patients' ages averaged at 49. The mean duration between the onset of the symptoms and the time of presentation was 22 months. Sixteen patients (14.3%) had bilateral lesions. Proptosis or local orbital mass was presented in 69 cases (61.6%). Reactive lymphoid hyperplasia was diagnosed in 11 cases (9.8%) and atypical lymphoid hyperplasia in 10 cases (8.9%). The rest 91 cases (81.3%) were diagnosed as lymphoma, among which 74 cases (81.3%) were extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-EMZL). CONCLUSIONS: MALT-EMZL is the most frequent type of ocular lymphoproliferative lesions in ocular adnexa. The ocular adnexal lymphoproliferative lesions show an indolent course clinically, tending to affect the old. Bilateral case is not uncommon.

Adolescent↗
PubMed1989

An overview of ocular adnexal lymphoid tumors.

In comparison with our earlier colleagues quoted in the introduction, we have made substantial progress in understanding the biology of ocular adnexal lymphoid tumors. While we have refined various categories with prognostic clinical value regarding possible associated systemic disease, none is foolproof and all have varying degrees of unpredictability. Comparatively well-differentiated histologic subtypes predominate among ocular adnexal lymphoid tumors. Polyclonal lesions occur less than half as often as monoclonal B-cell lesions. Molecular genetic studies have revealed small clones of monoclonal populations among the B-cells comprising most of the immunophenotypically polyclonal lesions, but no clonal genetic rearrangements have been uncovered within the preponderant constituent T-cell populations. The overall prognosis for ocular adnexal lymphoid tumors is excellent; when lumped together, 67% are not found to be associated with systemic disease with mean follow-ups of over 4 years. This is similar to experience with extranodal and extralymphatic lesions in other sites of the body, which also frequently have a small lymphocyte composition. The incidence of nonocular disease in all categories of our studies, however, will probably increase with the acquisition of longer follow-ups. Careful histopathologic evaluation is as good as immunophenotypic analysis of these lesions in predicting clinical outcome in terms of associated nonocular disease. Polyclonal and well-differentiated B-cell monoclonal lesions displayed equivalent clinical behavior. Benign polyclonal lesions may be associated with systemic disease but in a minority of cases (27%), as has also been determined in earlier studies. Clinical staging is the single most important predictor of associated monocular disease. In this study, patients with stage I-E disease had an 87% chance of not developing any nonocular lymphomatous lesion. We believe that this figure may also somewhat decrease with the passage of time. Precise anatomic localization of the lesion within the adnexa had considerable predictive value. Lesions of the conjunctiva fared the best; those of the orbit had an intermediate prognosis; while lid lesions had the worst prognosis. The most favorable prognosis would be held by a conjunctival lymphoid lesion in stage I-E composed of small lymphocytes. The fact that there is a fairly close equivalence in outcome between polyclonal and monoclonal well-differentiated lesions indicates that these lesions are in the vast majority of cases primary hyperplasias or primary lymphomas. The discovery by genetic probes of small monoclonal populations in immunophenotypically polyclonal lesions suggests that there is an evolution that goes on in situ.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1986

Adnexal surgery in pregnancy.

Adnexal pathology is a rare event in pregnancy, occurring once in 556 deliveries in this study period, during which 23 patients underwent surgery for it. Eleven patients in the first two trimesters received perioperative prophylactic progesterone without a pregnancy loss. Two of three patients beyond 20 weeks required tocolytic therapy for apparent premature labor. Dermoid cysts and torsion of a corpus luteum cyst were the most common pathologic findings. The type of incision employed was based on uterine size and expected location of the adnexal pathology. It appears that the risk to the pregnant patient undergoing adnexal surgery can be minimized with judicious timing of the operation, preoperative incision planning and modern anesthetic techniques. The use of prophylactic progesterone is unproven, and further studies of this therapeutic modality should be undertaken.

Female↗
PubMed1982

[Detection of gonorrhoea by laparoscopic diagnosis of acute adnexitis].

The presence of gonorrhoea was verified by culturing in 30.3 per cent of 119 patients in whom acute adnexitis had been confirmed by laparoscopy, gonorrhoeal findings being independent of types of inflammation.--Cervical, urethral, and abdominal cultures were prepared from various materials at one and the same time. Positive responses were recorded from them in one third of the cases of gonorrhoea. Three patients exhibited positive reactions only from abdominal cultures.--Additional aerobic and anaerobic pathogens were recorded from abdominal samples in 16 of 29 cases. Their occurrence should be taken into consideration in the treatment of female gonorrhoea with concomitant adnexitis.--A recommendation is made to the effect that abdominal gonorrhoeal cultures should be prepared in all cases of laparoscopy or laparotomy for acute adnexitis. Highest rates of detection can be expected, in that context, from tubal tissue cultures.--An approach is described by which to prepare gonorrhoeal cultures with no transport medium for conditions under which hospital and gonorrhoea laboratory are not located on one and the same premises.

Acute Disease↗
PubMed1984

Combined adnexal tumor of the skin.

Two patients had distinctive adnexal skin tumors that showed cellular differentiation toward the formation of more than one adnexal structure. In one patient, the tumor showed differentiation toward pilar and sweat ductal structures. In the second patient, tumor differentiation toward the formation of sebaceous glands, pilar, and sweat ductal structures was found. We propose the term "combined adnexal tumor of the skin" for this neoplasm.

Adenoma↗
PubMed1997

Evaluation of adnexal masses using three-dimensional ultrasonographic technology: preliminary report.

The purpose of the current study was to demonstrate the ability of three-dimensional ultrasonographic technology to enhance the morphologic scoring system and further improve the ability to differentiate benign from malignant ovarian masses. We performed conventional two-dimensional and three-dimensional transabdominal and transvaginal ultrasonography on eight women with adnexal masses. All patients underwent exploratory laparotomy or diagnostic laparoscopy. The three-dimensional ultrasonographic findings were compared with the two-dimensional ultrasonograms, the intraoperative observations, and gross and histopathologic findings. The morphologic scoring system as described by Sassone and coworkers was adopted, with scores of less than 9 suggestive of benign lesions, and this system was applied in both the two-dimensional and three-dimensional ultrasonographic examinations. The morphologic scores were subsequently compared. The images were dissected in the XYZ planes, and the areas suggestive of malignancy, as suggested by two-dimensional ultrasonography, were determined to be either negative or positive and confirmatory. In each of the eight adnexal masses, three-dimensional ultrasonography confirmed the preoperative diagnoses. The morphologic scores did not differ between two-dimensional and three-dimensional ultrasonograms for the benign cysts. In one case of benign solid fibroma, both the two-dimensional and three-dimensional gray scale morphologic scores were falsely positive at greater than 9. In one case of malignant serous papillary cystadenocarcinoma the two-dimensional morphologic score was a 9, where- as the three-dimensional score was 13. This difference in scores can be attributed to the additional views available with three-dimensional volume scanning, which allowed better characterization of the pathologic conditions. In addition, three-dimensional sonographic technology had the added advantage of high-speed image acquisition and recording to decrease the time of scanning to improve patient comfort. Furthermore, three-dimensional ultrasonography allowed the real-time analysis of the acquired image data to be conducted at a later time when the patient is off the examination table. Our preliminary results suggest that three-dimensional transvaginal ultrasonographic technology can enhance and facilitate the morphologic evaluation of both benign and malignant adnexal masses.

Adult↗
PubMed1998

[Microcystic sclerosing adnexal carcinoma: 2 case reports. Diagnostic and therapeutic difficulties].

Microcystic adnexal carcinoma is a recently described malignant neoplasm of adnexal structure. It remains frequently misdiagnosed. These tumors are characterized by their slow progression and by local aggressivity with local recurrences. The best treatment appears to be surgical excision with microscopically controlled margin. We report two cases of microcystic adnexal carcinoma recently observed at Institute Gustave Roussy.

Carcinoma, Skin Appendage↗
PubMedDate not supplied

Endoscopic management of adnexal masses.

BACKGROUND: The laparoscopic management of suspicious adnexal masses and early ovarian malignancies is discussed with the aim of maintaining accepted oncologic treatment principles. Comparative survival data of patients with gynecological malignancies managed by laparoscopy or laparotomy are still very scarce and the survival of cancer patients must not be compromised by new techniques. It is time to closely analyze laparoscopy and determine if it has a positive impact on the diagnosis and treatment of ovarian malignancies. In this paper we will address the following points: 1) Which ovarian cysts can be surgically treated by laparoscopy (pelviscopy)? 2) Is staging laparoscopy an accepted technique? 3) Is laparoscopy, as a second-look procedure, of benefit? 4) Is laparoscopic staging, together with histologic tissue sampling, adequate surgical technique in inoperable ovarian cancer with ascites and peritoneal carcinomatosis? 5) Does endoscopic biopsy of ovarian cancer stage Ia change the destiny of a patient into ovarian cancer Ic? DATA BASE: The above questions are analyzed based on our experience with the laparoscopic treatment of 1,225 patients with ovarian cysts and 165 ovarian cancer patients stage I to IV treated immediately by laparotomy during the years 1992-1995. CONCLUSIONS: Ovarian cystic tumors with no signs of malignancy can be dealt with by laparoscopic means with the option of immediate conversion to laparotomy or within one week if an ovarian malignancy is diagnosed. Today sampling laparoscopic lymphadenectomy of both pelvic and para-aortic is feasible and adequate. On a curative level, the number of lymph nodes to be resected has yet to be determined. The adnexa can be extracted from the abdominal cavity with bag extraction without the danger of spillage. The uterus can be removed transvaginally with laparoscopic assisted vaginal hysterectomy (LAVH). We must be cautious to advocate laparoscopy for ovarian cancer. However, it is an excellent tool when used as a staging procedure. A careful preoperative screening of the patient and an exact definition of existing cysts with imaging techniques allows us to frequently apply laparoscopic surgery for ovarian cysts, leaving only readily detectable cancer cases for laparotomy. Many gynecological oncologists employing staging and second-look procedures for ovarian cancer agree that initiating a case with laparoscopy may preclude laparotomy for many patients. Tumor propagation by performing a biopsy in FIGO stage Ia ovarian cancer patients does not occur if the patient receives adequate radical surgical treatment within one week. According to the reports of Sevelda et al. and Dembo et al., the degree of differentiation and the existence of ascites are more relevant to decreasing the five-year survival rate of patients with ovarian cancer stage I than the rupture of capsule or penetration of the tumor. A dependency on the first two parameters was found in these two large statistical studies. As the question of endoscopic operations for adnexal mass is predominantly put for the sanitation of small ovarian tumors (ovarian tumors with solid particles in the cysts can be put into the section of primary laparotomies) there remains a wide field of indications for the laparoscopic treatment of adnexal mass and ovarian cysts with benign indications. For many young patients with non-malignant ovarian lesions such as endometriosis, benign cysts, benign cystic proliferations and fibromas, a laparotomy can be avoided and these lesions treated by laparoscopy.

Adolescent↗
PubMedDate not supplied

Sonographic and MRI findings in prepubertal adnexal hemorrhagic cyst with torsion.

Adnexal torsion is rare before menarche. We report the case of a 10-year-old girl with persistent left lower quadrant pain proven by surgery to be caused by adnexal torsion due to a hemorrhagic cyst. Sonography showed a well-defined, complex, predominantly solid mass with some sound through-transmission and a small amount of fluid. The left ovary could not be distinguished from the mass; the right ovary appeared normal. Doppler sonography demonstrated no blood flow within the mass. MRI revealed a circumferential region of high signal intensity in the periphery of the mass and multiple hyperintense foci in the left ovary.

Adnexal Diseases↗
PubMedDate not supplied

Prenatal magnetic resonance imaging assisting in differentiating between large degenerating intramural leiomyoma and complex adnexal mass during pregnancy.

We present an unusual case in which a 36-year-old patient was referred due to increasing upper left quadrant abdominal pain and a possible left adnexal mass at 22 weeks' gestation. Ultrasonography demonstrated a multiseptated cystic mass, with solid components measuring 12 cm in diameter. A thin sonolucency was thought to separate the mass from the uterus and thus the mass was considered consistent with an adnexal mass, possibly a mucinous cystadenoma. A large degenerating leiomyoma could not be ruled out with certainty and magnetic resonance (MR) imaging was performed which depicted a thin band of myometrium encompassing the complex mass and was therefore diagnostic of a degenerating uterine leiomyoma. We discuss the contribution of MR imaging in the noninvasive diagnosis of undetermined solid pelvic masses visualized ultrasonographically.

Abdominal Pain↗
PubMed1994

Transvaginal sonographic characterization combined with cytologic evaluation in the diagnosis of ovarian and adnexal cysts.

A transvaginal sonographic (TVS) scoring system using morphologic features has been developed at our institution to maximize discrimination between benign and malignant ovarian and adnexal cysts. Low (4-7) or intermediate (8-9) scores have been found to correlate with benignity, hence TVS-guided or laparoscopically directed needle aspiration of low-scoring lesions may safely be performed. High-scoring lesions (10-14) are often malignant, therefore in situ needle aspiration of such lesions is not recommended. The aim of our study was to correlate the results of TVS characterization of ovarian and adnexal cysts with the aspiration cytologic evaluation. Twenty-three of the 43 cysts studied were aspirated in situ from the patient; 20 were aspirated from resected surgical specimens. Thirty-six benign cysts had TVS scores ranging from 4 to 12, with a median score of 7. All 25 cysts that were benign by TVS and/or histology were also cytologically benign as well as an additional 11 cysts that were not resected (TVS scores: 4 to 9). Seven cytologically and histologically malignant cysts had high TVS scores (TVS scores 10-14; median = 12). The combination of TVS and needle aspiration cytology is valuable, particularly in the diagnosis of cysts having low or intermediate TVS scores and benign cytology. Aspiration of cysts or masses with high TVS scores is not recommended. This combined evaluation may allow a more limited surgical approach, such as operative laparoscopy, or, in some cases, obviate the need for operative treatment altogether.

Adnexal Diseases↗