Approach to the patient with an adnexal mass
- Michael G Muto, MD
Michael G Muto, MD
- Associate Professor of Obstetrics, Gynecology, and Reproductive Biology
- Harvard Medical School
- Section Editors
- Howard T Sharp, MD
Howard T Sharp, MD
- Section Editor — Gynecologic Surgery
- Professor and Vice Chair for Clinical Activities
- Department of Obstetrics and Gynecology
- University of Utah Health Sciences Center
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Department Chair, Gynecologic Oncology
- University of Washington Medical Center
An adnexal mass (mass of the ovary, fallopian tube, or surrounding connective tissues) is a common gynecologic problem. In the United States, it is estimated that there is a 5 to 10 percent lifetime risk for women undergoing surgery for a suspected ovarian neoplasm . Adnexal masses may be found in females of all ages, fetuses to the elderly, and there is a wide variety of types of masses (table 1). The principal goals of the evaluation are to address acute conditions (eg, ectopic pregnancy) and to determine whether a mass is malignant.
The initial approach to and an overview of the evaluation of patients with an adnexal mass are reviewed here. Management of an adnexal mass and other related topics are discussed separately:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CLINICAL APPROACH
- Excluding urgent conditions or malignancy
- Anatomic location
- Age and reproductive status
- - Children and adolescents
- - Premenopausal women
- Pregnant women
- - Postmenopausal women
- GENERAL EVALUATION
- Medical history
- Physical examination
- Imaging studies
- Laboratory evaluation
- EVALUATION FOR URGENT CONDITIONS
- First trimester bleeding or pain
- - Ectopic pregnancy
- Acute pelvic or abdominal pain
- - Adnexal torsion
- - Ruptured or hemorrhagic ovarian cyst
- - Tuboovarian abscess
- EVALUATION FOR MALIGNANCY
- Initial evaluation
- - Medical history
- - Physical examination
- - Imaging studies
- - Laboratory studies
- Serum markers for epithelial ovarian carcinoma
- Serum markers for other histologic types
- Surgical exploration
- REFERRAL TO A SPECIALIST
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS