Retrospective assessment of 424 cases and review of the literature

Abstract

Objective: To review the pathological diagnosis of patients underwent laparotomy for adnexal masses accompanied by the literature. Material and Methods: The results of 424 patients from a single center were evaluated. Research criteria include the patient to be of reproductive age or postmenopausal age, CA-125 levels, ascites, bilaterality and whether the pathologic diagnosis of the mass is benign or malignant. Results: 200 (47.17%) patients were in the reproductive period, 224 (52.83%) patients were in the postmenopausal period, the average age of the population was 52.65±1.04. Adnexal masses originated from; ovary 385 (90.8%), tuba 22 (5.18%), uterus 3 (0.7%) and distant organs 14 (3.3%). While 18.51% of patients pathologically diagnosed as benign were bilateral, 56.89% of malign patients were bilateral. The presence of the acid was observed in 4.2% of benign patients and in 37.06% of the malign patients. The malignancy was diagnosed in 48 (24%) patients in the reproductive period and 68 (30.35%) patients in the postmenopausal period for laparotomies performed for adnexal masses. The most common benign pathologies in the reproductive period was serous cystadenoma, endometrioma and mucinous cystadenoma, while in the postmenopausal period was serous cystadenoma, mucinous cystadenoma and mature teratoma. The most common malignant pathologic diagnosis in the reproductive period was serous adenocarcinoma, metastatic cancers and endometrioid adenocarcinoma, while in the postmenopausal period was serous adenocarcinoma, mucinous carcinoma and endometrioid adenocarcinoma. Metastatic cancers are more frequent during the reproductive years, the most common benign pathology in both groups was ovarian serous cystadenomas, and malignant pathology in both groups was ovarian serous cystadenocarcinoma. 21 malignant cases (43.75%) in the reproductive period has a CA-125 value higher than 200 mU/ml, while 60 malignant cases (88.20%) in the postmenopausal period has a CA-125 value higher than 35 mU/ml. Conclusion: Ovarian pathologies constitute the majority of the adnexal masses. The probability of malignancy increases with advancing age, bilaterality, presence of ascites and high CA-125 values. The frequency of metastatic ovarian cancers in the reproductive period is the characteristic of series. © 2016 by Türkiye Klinikleri.