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Adnexal Mass A Condition Requiring Closer Attention

An adnexal mass is any mass located in the pelvic region that includes the ovaries, fallopian tubes, round ligaments, and other structures. Adnexal masses can be physiologic, infectious, non-neoplastic, or neoplastic. Common causes include follicular cysts, endometriosis, ovarian tumors, and ectopic pregnancies. Diagnosis involves history, physical exam including bimanual exam, ultrasound, and blood tests like CA-125. Management depends on patient age and test results, with malignant tumors being more common in post-menopausal women.

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Nur Sayeeda
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225 views16 pages

Adnexal Mass A Condition Requiring Closer Attention

An adnexal mass is any mass located in the pelvic region that includes the ovaries, fallopian tubes, round ligaments, and other structures. Adnexal masses can be physiologic, infectious, non-neoplastic, or neoplastic. Common causes include follicular cysts, endometriosis, ovarian tumors, and ectopic pregnancies. Diagnosis involves history, physical exam including bimanual exam, ultrasound, and blood tests like CA-125. Management depends on patient age and test results, with malignant tumors being more common in post-menopausal women.

Uploaded by

Nur Sayeeda
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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ADNEXAL MASS

A condition requiring closer


attention

Dr.Nur sayeeda
Assistant professor
Obstretics &Gynaecology
Dhaka Medical college
Defination
• Anatomicaly the adnexae encompases the
region whithin the pelvis that includes the
ovaries,fellopian tubes round ligaments &
structures arising from embryologigal rests so-
Any mass occuping this region is Adnexal
mass or tubo-ovarian mass
Etiology of adnexal mass
it may be-

a. physiologic- follicular cyst


lutual cyst
b.infectious- hydrosulphinx
pyosulphinx T-o mass,appendicular lump,diverticulities.
C.Non neoplastic-
ectopic pregnancy
pedunculated myoma,pelvic
kidney,endometioma,PCO

D.Neoplastic-ovarian
tumour-benign
malignant
Clinical presentation of adnexal mass

.Acute onset of lower abdominal pain


.Chronic ,intermittent pain
.Dysmenorrhia,menstrual disturbance
.Non-specific symptoms- anorexia,nausia
loss of weight etc
.Bladder symptoms-
.No symptoms -
Diagnosis of adnexal mass
• A.History-
Age-. young age- germ cell tumour
. Following menarche –
follicular&corpus luteal cyst
. Reproductive age group-
PCO,endometriosis,ectopic ,T-O mass

. After menopause-malignancy
Diagnosis-continue
• Pain-due to distension of ovarian
capsule&compression of adjacent structure
a.Location
b.radiation
c.quality
d.time of onset
. Menstrual disturbance-
. Others-
B.Physical Examination
• a.General examination-including lyphnode palpation
&breast examination
• b.Bimanual examination-
size,shape,consistency,mobility,tenderness.
• C.Recto-Vaginal examination-

a complex mass in cul-de-sac


+nodularity+tander utero-sacral ligament>Endomtiosis in
pre-menopausal women but malignancy in post-
menopausal women
c.Ultrasound evaluation
• a.Complexity-
• b.contour-smooth/excrescences
• c.Presence of internal septa/papillae
• d.Ascities

Colour flow doppler scanning-to study blood


flow,to measure R1,P1.
Labaratory test
• Complete blood picture-
• M-T ,VDRL,TPHA etc-
• Serum B- HCG-
• Serum tumour marker –alfa-fetoprotein ↑ -
endodermal sinus tumour
lactic dehydrogenase ↑-
dysgermina
B-HCG↑- non gestational chorionic carcinoma
Serum CA -125-
Serum CA -125
• Normal value –less than 35u/ml
It may increase in some benign condition(upto-
100u/ml)-Liomyoma,non malignant ovarian
tumour,liver disease,
adenomyosis,endometriosis,pregnancy,PID etc.
Malignant conditions are –Serous epithelial
ovarian carcinoma,breast,colon,lung &
pancreatic cancer.
In premenopausal women the
common adnexal mass are-
Ovarian cyst
Tubal pregnancy
Benign &malignant tumour
Endometrioma
PCO
T-O mass
In post-menopausal women those are-

Cancer
Fibroid
Fibroma
Diverticular abscess
Managementment of Adnexal mass

• Depends upon- Age


• Result of the work-up
• In pre menousal women-
Management of adnexal mass in post
menopausal women
Thank you

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