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PubMed1958

[Adnexitis].

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Female↗
PubMed2001

Preoperative assessment of unilocular adnexal cysts by transvaginal ultrasonography: a comparison between ultrasonographic morphologic imaging and histopathologic diagnosis.

OBJECTIVE: Our purpose was to evaluate the risk of malignancy in surgically removed ovarian cysts that were characterized before the operation as unilocular according to transvaginal ultrasonography. STUDY DESIGN: This prospective analysis included 927 premenopausal women and 377 postmenopausal women operated on at 2 European university hospitals between January 1992 and December 1997. On the basis of ultrasonographic findings the cysts were characterized either as echo-free, without solid parts or papillary formations (group 1), or as having echogenic cyst content, with solid parts or papillary formations (group 2). Ultrasonographic and macroscopic appearances of the cysts were compared with histopathologic diagnosis. RESULTS: In group 1, in premenopausal women 3 of 413 cysts (0.73%) proved to be borderline or malignant, and in postmenopausal women 4 of 247 cysts (1.6%) proved to be borderline or malignant. The figures for cysts in group 2 were 11 of 514 cysts (2.1%) and 13 of 130 cysts (10.0%), respectively. It was not possible to differentiate by transvaginal ultrasonography between benign, borderline, and malignant cysts when solid parts or papillary formations were visualized. CONCLUSIONS: This study confirmed that the risk of malignancy associated with unilocular echo-free cysts (group 1) was low. Serial ultrasonographic follow-up should therefore be the standard procedure with unilocular echo-free cysts <50 mm in diameter. In cysts with a mean diameter of >50 mm, papillary formations or solid parts may be missed by transvaginal ultrasonography. The risk for malignancy in cysts containing papillary formations or solid parts (group 2) was 3 to 6 times higher than that in unilocular echo-free cysts.

Adnexal Diseases↗
PubMed1994

Laparoscopic unwinding of adnexal torsion caused by ovarian hyperstimulation.

A case of laparoscopic unwinding of a twisted enlarged ovary and Fallopian tube caused by ovarian hyperstimulation is presented. The laparoscopic unwinding was simple and was carried out in a short time. The patient's post-operative course was uneventful. Complications such as thromboembolism were not observed and the post-operative ovarian function was well preserved after such procedures. Preservation of the ovary is highly important in young infertile women. Prompt diagnosis with an immediate unwinding of the twisted adnexa by a laparoscopic technique can produce a valuable outcome.

Adnexal Diseases↗
PubMedDate not supplied

Metastatic adnexal trophoblastic neoplasm: contribution of MR imaging.

We report a case of pathologically proven metastatic trophoblastic neoplasm involving the adnexa which occurred after dilatation and curettage and chemotherapy. Duplex doppler ultrasound demonstrated increased vascularity in the adnexa. Angiography was sensitive but did not decisively distinguish between tumor in the adnexa and arteriovenous fistula in the uterus. In addition to abnormal vascularity, magnetic resonance also showed foci of abnormal signal in the adnexa not seen in the uterus and correctly suggested the presence of tumor.

Adnexal Diseases↗
PubMedDate not supplied

MR evaluation of clinically suspected adnexal masses.

OBJECTIVE: Our goal was to determine the sensitivity, specificity, predictive value, and accuracy of pelvic MRI in the prospective evaluation of women with a clinically suspected pelvic mass. MATERIALS AND METHODS: One-hundred three patients with clinically suspected pelvic masses were prospectively evaluated by pelvic MRI. Masses were analyzed for size, location, morphological characteristics, and signal behavior. Masses were classified as benign, malignant, or indeterminate and in every case an attempt was made to generate a specific diagnosis according to previously reported characteristic MR appearances. Surgical follow-up was obtained within 3 months of MRI examination for all patients, excepting 11 patients with typically appearing leiomyomas. RESULTS: One hundred twenty pelvic masses were confirmed. Magnetic resonance was 100% sensitive and 99% specific in prospectively diagnosing dermoids, 96% sensitive and 100% specific in diagnosing subserosal leiomyomas, and 92% sensitive and 91% specific in diagnosing endometriomas. CONCLUSION: When physical examination or ultrasound examination is inconclusive, pelvic MRI can aid in the evaluation of women with a suspected pelvic mass. By identifying these common benign gynecologic conditions, unnecessary surgery can be avoided.

Adnexal Diseases↗