Diagnosis and management of adnexal masses

Vanessa Givens, Gregg Mitchell, Carolyn Harraway-Smith, Avinash Reddy, David L. Maness

Research output: Contribution to journalReview article

30 Citations (Scopus)

Abstract

Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. They may be benign or malignant. The initial detection and evaluation of an adnexal mass requires a high index of suspicion, a thorough history and physical examination, and careful attention to subtle historical clues. Timely, appropriate laboratory and radiographic studies are required. The most common symptoms reported by women with ovarian cancer are pelvic or abdominal pain; increased abdominal size; bloating; urinary urgency, frequency, or incontinence; early satiety; difficulty eating; and weight loss. These vague symptoms are present for months in up to 93 percent of patients with ovarian cancer. Any of these symptoms occurring daily for more than two weeks, or with failure to respond to appropriate therapy warrant further evaluation. Transvaginal ultrasonography remains the standard for evaluation of adnexal masses. Findings suggestive of malignancy in an adnexal mass include a solid component, thick septations (greater than 2 to 3 mm), bilaterality, Doppler flow to the solid component of the mass, and presence of ascites. Family physicians can manage many nonmalignant adnexal masses; however, prepubescent girls and postmenopausal women with an adnexal mass should be referred to a gynecologist or gynecologic oncologist for further treatment. All women, regardless of menopausal status, should be referred if they have evidence of metastatic disease, ascites, a complex mass, an adnexal mass greater than 10 cm, or any mass that persists longer than 12 weeks.

Original languageEnglish (US)
JournalAmerican Family Physician
Volume80
Issue number8
StatePublished - Oct 15 2009

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Ascites
Ovarian Neoplasms
Pelvic Pain
Family Physicians
Abdominal Pain
Physical Examination
Weight Loss
Ultrasonography
Eating
History
Therapeutics
Neoplasms
Oncologists
Cancer Pain

All Science Journal Classification (ASJC) codes

  • Family Practice

Cite this

Givens, V., Mitchell, G., Harraway-Smith, C., Reddy, A., & Maness, D. L. (2009). Diagnosis and management of adnexal masses. American Family Physician, 80(8).

Diagnosis and management of adnexal masses. / Givens, Vanessa; Mitchell, Gregg; Harraway-Smith, Carolyn; Reddy, Avinash; Maness, David L.

In: American Family Physician, Vol. 80, No. 8, 15.10.2009.

Research output: Contribution to journalReview article

Givens, V, Mitchell, G, Harraway-Smith, C, Reddy, A & Maness, DL 2009, 'Diagnosis and management of adnexal masses', American Family Physician, vol. 80, no. 8.
Givens V, Mitchell G, Harraway-Smith C, Reddy A, Maness DL. Diagnosis and management of adnexal masses. American Family Physician. 2009 Oct 15;80(8).
Givens, Vanessa ; Mitchell, Gregg ; Harraway-Smith, Carolyn ; Reddy, Avinash ; Maness, David L. / Diagnosis and management of adnexal masses. In: American Family Physician. 2009 ; Vol. 80, No. 8.
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