Conservative Management of Asymptomatic Adnexal Masses Classified as Benign by the IOTA ADNEX Model: A Prospective Multicenter Portuguese Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion and Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Premenopausal Women, n (%) | Postmenopausal Women, n (%) |
---|---|---|
Nulliparous | 126 out of 260 (48.5%) | 23 out of 205 (11.2%) |
Using hormonal contraception/menopausal hormonal replacement | 50 (19.2) | 11 (5.3) |
Personal history of breast cancer | 18 (6.9) | 26 (12.7) |
Personal history of ovarian cancer | - | - |
Personal history of previous ovarian surgery | 24 (9.2) | 10 (4.9) |
Previous Hysterectomy | 14 (5.3) | 29 (14.1) |
Patient Group (Total Number of Masses, Percentage) | Premenopausal Women (n = 328, 57.2%) | Postmenopausal Women (n = 245, 42.8%) |
---|---|---|
Diameter of the lesion (mm) | ||
Maximum | 140 | 135 |
Median (SD) | 50.2 (20.7) | 46.7 (19.2) |
Tumour type using IOTA terminology | ||
Unilocular | 202 (61.6%) | 106 (43.3%) |
Unilocular—solid | 9 (2.7%) | 12 (4.9%) |
Multilocular | 90 (27.4%) | 90 (36.7%) |
Multilocular—solid | 4 (1.2%) | 4 (1.6%) |
Solid | 23 (7%) | 33 (13.5%) |
Ultrasound examiner’s subjective assessment | ||
Simple, para-ovarian or salpingeal cyst | 44 (13.4%) | 31 (12.7%) |
Serous cystadenoma | 56 (23.5%) | 119 (48.6%) |
Mucinous cystadenoma | 12 (3.7%) | 5 (2%) |
Endometrioma | 98 (30%) | 6 (2.4%) |
Teratoma | 39 (13.3%) | 14 (5.7%) |
Fibroma of fibrothecoma | 21 (6.4%) | 34 (13.9%) |
Hydrosalpinx | 40 (12.2%) | 15 (6.1%) |
Serous cystadenofibroma | 8 (2.4%) | 12 (4.9%) |
Abscess, salpingitis or pelvic inflammatory disease | 5 (1.5%) | 5 (2%) |
Inclusion or peritoneal cyst | 1 (0.3%) | 3 (1.2%) |
Not possible to define | 4 (1.2%) | 1 (0.4%) |
Patient Group (Total Number of Masses, Percentage) | Premenopausal Women (n = 328, 57.2%) | Postmenopausal Women (n = 245, 42.8%) |
---|---|---|
Spontaneous resolution | 73 (22.3%) | 21 (8.6%) |
Persistent mass under conservative management | 187 (57%) | 189 (77.1%) |
Increasing complexity | 12 (3.7%) | 10 (4%) |
Persistent adnexal mass annual growth (%), median [mean ± SD] | 23.2 ± 176 | 10.8 ± 62 |
Going under surgery | 68 (20.7%) | 35 (14.3%) |
Indication for surgery | ||
| 17 (25%) | 11 (31.4%) |
| 6 (8.8%) | - |
| 24 (35.3%) | 24 (68.6%) |
| 21 (30.9%) | - |
Complications: | ||
| - | 1 (0.5%) * |
| 1 (0.3%) ** | - |
| 1 (0.3%) *** | - |
| - | - |
No mass complications | 292 (99.3%) | 244 (99.6%) |
Adnexal Masses with Spontaneous Resolution, (n = 94, 16.4%) | ||
---|---|---|
Patient Group (Total Number of Masses, Percentage) | Premenopausal Women (n = 73, 80.2%) | Postmenopausal Women (n = 21, 23.1%) |
Diameter of the lesion (mm) | ||
Range | 31–119 | 34–67 |
Median (± SD) | 45.6 ± 16.4 | 42.3 ± 12.3 |
Time interval to resolution (months) (median ± SD) | ||
Median ± SD | 11 ± 10 | 18.6 ± 10 |
In the first year of follow-up | 41 (56.2%) | 5 (23.8%) |
Tumour type using IOTA terminology | ||
Unilocular | 42 (57.5%) | 6 (33.3%) |
Unilocular—solid | - | - |
Multilocular | 30 (41.1%) | 15 (83.3%) |
Multilocular—solid | - | - |
Solid | - | - |
Ultrasound examiner’s subjective assessment | ||
Simple, para-ovarian or salpingeal cyst | 23 (31.5%) | 3 (14.3%) |
Serous cystadenoma | 17 (23.3%) | 6 (28.6%) |
Mucinous cystadenoma | 1 (1.4%) | - |
Endometrioma | 10 (13.7%) | 2 (9.5%) |
Teratoma | - | - |
Hydrosalpinx or salpingitis | 15 (20.5%) | 9 (42.9%) |
Abscess, salpingitis or pelvic inflammatory disease | 4 (5.5%) | - |
Inclusion or peritoneal cyst | - | 1 |
Serous cystadenofibroma | - | - |
Not possible to define | 3 (4.1%) | - |
Adnexal Masses with Increased Complexity, n = 22 | |
---|---|
Presumptive Histology Class (Sonographer Subjective Assessment at 1st Evaluation) | n (%) |
Simple, para-ovarian or salpingeal cyst | 3 (13.6%) |
Serous cystadenoma | 11 (50%) |
Mucinous cystadenoma | - |
Endometrioma | 2 (9%) |
Teratoma | - |
Fibroma of fibrothecoma | - |
Hydrosalpinx | 3 (13.6%) |
Serous cystadenofibroma | - |
Abscess, salpingitis or pelvic inflammatory disease | 2 (9%) |
Inclusion or peritoneal cyst | - |
Not possible to define | 1 (4.5%) |
Adnexal Masses Going Under Surgery, (n = 103, 18%) | |
---|---|
Simple, paraovarian or parasalpingeal cyst | 3 (2.9%) |
Endometrioma | 19 (18.4%) |
Teratoma | 14 (13.6%) |
Serous cystadenoma | 27 (26.2%) |
Mucinous cystadenoma | 8 (7.8%) |
Fibroma | 10 (9.7%) |
Hydrosalpinx or salpingitis | 8 (7.8%) |
Peritoneal pseudocyst | 1 (1%) |
Brenner tumour | 1 (1%) |
Serous cystadenofibroma | 9 (8.7%) |
Mucinous cystadenofibroma | 1 (1%) |
Invasive malignancy | 1 (1%) |
Borderline tumour | 1 (1%) |
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Brito, M.E.; Borges, A.; Rodrigues, S.; Ambrósio, P.; Condeço, R.; Lacerda, A.; Bernardo, M.J.; Pinto, P.; Djokovic, D. Conservative Management of Asymptomatic Adnexal Masses Classified as Benign by the IOTA ADNEX Model: A Prospective Multicenter Portuguese Study. Diagnostics 2021, 11, 1992. https://doi.org/10.3390/diagnostics11111992
Brito ME, Borges A, Rodrigues S, Ambrósio P, Condeço R, Lacerda A, Bernardo MJ, Pinto P, Djokovic D. Conservative Management of Asymptomatic Adnexal Masses Classified as Benign by the IOTA ADNEX Model: A Prospective Multicenter Portuguese Study. Diagnostics. 2021; 11(11):1992. https://doi.org/10.3390/diagnostics11111992
Chicago/Turabian StyleBrito, Marta Espanhol, André Borges, Sofia Rodrigues, Paula Ambrósio, Raquel Condeço, Abílio Lacerda, Maria José Bernardo, Patrícia Pinto, and Dusan Djokovic. 2021. "Conservative Management of Asymptomatic Adnexal Masses Classified as Benign by the IOTA ADNEX Model: A Prospective Multicenter Portuguese Study" Diagnostics 11, no. 11: 1992. https://doi.org/10.3390/diagnostics11111992