ONCOGYNECOLOGICAL ASPECTS ОF ADNEXAL MASSES

Cover Page


Cite item

Full Text

Abstract

Adnexal masses are frequently found in both symptomatic and asymptomatic women. The frequency of them is 7,8% in reproductive aged women and 2,5–18% in postmenopausal patients. Aim: to investigate clinical significance of the Risk of Malignancy Index (RMI) and to compare it with histological findings in patients with adnexal masses. Patients and methods: 345 patients with adnexal masses were evaluated. Depending on the menopausal status, serum CA-125 level and ultrasonographic findings RMI scores were calculated for each of patients. Results: according to RMI all the patients were divided in to two groups: first group — 283 (62%) of patients with RMI less then 200 and the second group — 52 (38%) women with RMI more then 200. The patients of the second group were referred to the oncologist. Among the patients with RMI <200, 137 (48,4%) endometriomas, 73 (25,8%) serous cystadenoma, 45 (15,9%) dermoid cysts, 22 (7,8%) paraovarian cysts, 2 (0,7%) adenocarcinoma were detected after histological examination. In patients with RMI >200, 25% of benign ovarian tumors, 34,6% of borderline and 40,4% of malignant tumors were verified. Conclusions: RMI when used in the presence of a pelvic mass is a useful triage tool to determine those women who should be referred to a gynaecological oncologist. During laparoscopy, in cases of intraoperative malignancy suspicion staging should be performed: videorecord of the surgery, biopsy of the adnexal mass and contralateral ovary, biopsy of the omentum and peritoneum, and aspiration of the peritoneal fluid for cytological examination.

About the authors

A. S. Gasparov

People’s Friendship University of Russia, Moscow, Russian Federation

Author for correspondence.
Email: 7767778@mail.ru
PhD, professor, member of RANS, Head of the Department of Plastic and Reconstructive Surgery and Reproductive Medicine of the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Postgraduate Education, People's Friendship University of Russia Address: 117198, Moscow, Miklukho-Maklaya St., 8; tel.: (495) 434-10-60 Russian Federation

K. I. Zhordania

Blokhin Russian Oncological Scientific Centre RAMS, Moscow, Russian Federation

Email: kiazo2@yandex.ru
PhD, professor of N.N. Blokhin Russian Cancer Research Center of RAMS, Department of Reproductive Medicine and Surgery, A.E. Evdokimov Moscow State Medico-Stomatological University, member of the Moscow Society of Oncologists, member of the International Society of Gynecological Oncology (International Gynecologic Cancer Society) Address: 115478, Moscow, Kashirskoe highway, 24; tel.: (499) 324-19-19 Russian Federation

Yu. G. Payanidi

Blokhin Russian Oncological Scientific Centre RAMS, Moscow, Russian Federation

Email: paian-u@rambler.ru
PhD, (N. N. Blokhin Russian Cancer Research Center RAMS), professor of the Faculty of Advanced Training of health care professionals, People's Friendship University of Russia, member of the Moscow Society of Oncologists. Address: 115478, Moscow, Kashirskoe highway, 24; tel.: (499) 324-19-19 Russian Federation

E. D. Dubinskaya

People’s Friendship University of Russia, Moscow, Russian Federation

Email: eka-dubinskaya@yandex.ru
PhD, associate professor of the Department of Obstetrics, Gynecology and Reproductive Medicine of Faculty of Postgraduate Education, People's Friendship University of Russia Address: 117198, Moscow, Miklukho-Maklaya St., 8; tel.: (495) 434-10-60 Russian Federation

References

  1. Kuivasaari-Pirinen P, Anttila M. Ovarian cysts. Duodecim. 2011; 127 (17): 1857–1863.
  2. Zhordania K.I. Some aspects of diagnosis and ovarian cancer treatment. RMZh. Onkologiya = Breast cancer. Oncology. 2002; 10 (24): 1095–1102.
  3. American College of Obstetricians and Gynecologists (ACOG). Management of adnexal masses. Washington (DC): American College of Obstetricians and Gynecologists (ACOG). 2007. 14 p. (ACOG practice bulletin; no. 83). [116 references]
  4. Anton C., Carvalho F.M., Oliveira E.I. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses. Clinics (Sao Paulo). 2012; 67 (5): 437–441.
  5. Gelbaya T.A., Nardo L.G. Evidence-based management of endometrioma. Reprod. Biomed. Online. 2011; 23 (1): 15–24.
  6. Tsoumpou I., Kyrgiou M., Gelbaya T.A., Nardo L.G. The effect of surgical treatment for endometrioma on in vitro fertilization outcomes: a systematic review and meta-analysis. Fertil. Steril. 2009; 92 (1): 75–87.
  7. Krasnopol'skii V.I., Popov A.A., Slobodyanyuk B.A. Laparoscopy and Ovarian Cancer. Onkoginekologiya = Oncogynecology. 2012; 4: 69–73.
  8. Tingulstad S., Hagen B., Skjeldestad F.E. et al: Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses. Brit. J. Obstet. Gynaecol. 1996; 103 (8): 826–831.
  9. Jacobs I., Oram D., Fairbanks J. et al. A risk of malignancy index incorporating CA125, ultrasound and menopausal status for the accurate pre-operative diagnosis of ovarian cancer. Brit. J. Obstet. Gynaecol. 1990; 97: 922–929.
  10. Watcharada M., Pissamai Y. The risk of malignancy index (RMI) in diagnosis of ovarian malignancy. Asian Pacific J. Cancer Prev. 2009; 10: 865–868.
  11. Anton C., Carvalho F.M., Oliveira E.I. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA), and risk malignancy index (RMI) for the classification of ovarian masses. Clinics (Sao Paulo). 2012; 67 (5): 437–441.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 1970 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies