Management Adnexal Masses

Funtional or physiologix- follicles, hemorrhagic, corpus luteal

Inflammatory- PID, endometrioma

Other benign-paratubal cysts, hydrosalpinx, ectopic, ovarian torsion

Benign neoplasms-

• Germ cell- mature teratoma
• Sex cord- fibroma
• Epithelial- serous or mucinous cystadenoma

Malignant-

• Germ cell- dysgerminoma, immature teratoma
• Sex cord- granulose cell tumor, epithelial ovarian cancer
• Borderline or low malignant potential- invasive epithelial, fallopian tube cancinoma

Risk factors-

• Age- most important independent factor
• Family history- 10% germline mutation (more 90% BRCA1/BRCA2 and 10% mutations) associated with Lynch syndrome (hereditary nonpolyposis colorectal cancer syndrome)
• BRCA1 40-45% risk, BRCA2/HNPCC 10-20% risk

Evidence of vertical

Features suggestive of such mutations in an individual family-

• Multiple relatives with breast cancer, ovarian cancer, colon, GI, endometrial, pancreatic
• Women with more than one primary cancer, such as bilateral breast plus ovarian
• Cancer diagnosed in a family member younger than 50
• Evidence of vertical transmission in two or more generations

Symptoms: bloating, pelvic pain, early satiety, urinary urgency or frequency

Risks associated with increased ovarian cancer nulliparity, early menarche, and late menopause