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What Is the Treatment for an Adnexal Mass?

Rebecca Harkin
Rebecca Harkin

An adnexal mass is an abnormal growth in and around the area of the uterus, including luteum cysts, ectopic pregnancies, polycystic ovaries, and benign or malignant tumors. The treatment for these masses depends on the age of the woman, her symptoms, CA-125 blood tests results, and the size and structure of the adnexal mass. Small cyst-like masses are typically watched to see if they will be naturally reabsorbed. A large mass is reviewed using laparoscopic surgery, removed, and pathologically studied to determine if it is malignant.

For young girls between birth and the beginning of menstruation, an adnexal mass needs to be carefully and quickly reviewed using an ultrasound scan. This prompt evaluation is essential because it is unlikely that benign masses are present prior to reproductive age. Laparoscopic surgery will typically follow to remove and pathologically review the mass.

Following surgery for an adnexal mass, the patient may undergo chemotherapy treatments.
Following surgery for an adnexal mass, the patient may undergo chemotherapy treatments.

An adnexal mass in a premenopausal women will be reviewed with an ultrasound scan to determine the size and texture of the abnormality. A mass that is greater than 3.9 inches (10 cm) and solid will require laparoscopic surgery. During surgery, the mass will be removed and pathologically reviewed. Following extraction of the mass, the surrounding area will be observed for metastasis or any additional masses missed by the ultrasound.

Adnexal masses occur in and around the uterus.
Adnexal masses occur in and around the uterus.

Adnexal masses in premenopausal women less than 3.9 inches (10cm) that are cyst-like or fluid filled will be watched for approximately four to six weeks. Oral contraception may be given to control hormone levels and help shrink the mass. Most masses are reabsorbed during this period of time. If the mass grows during this time, exploratory laparoscopic surgery will be ordered to look at the mass, remove it, and pathologically review the tissue.

A large adnexal mass is reviewed and removed using laparoscopic surgery.
A large adnexal mass is reviewed and removed using laparoscopic surgery.

When a postmenopausal woman has an adnexal mass, a complete gynecological exam will be ordered. This will include a Papanicolaou smear, CA-125 blood test and an ultrasound. The CA-125 blood test looks for the benign and malignant tumor marker, CA-125. If the postmenopausal woman has a normal gynecological exam, Papanicolaou smear, CA-125 serum level, and the mass is less than 1.2 inches (3 cm), it will be watched and monitored using periodic ultrasound scans and CA-125 blood tests.

If a postmenopausal woman has an adnexal mass, a complete gynecological exam will be performed.
If a postmenopausal woman has an adnexal mass, a complete gynecological exam will be performed.

If the gynecological exam and Papanicolaou smear are normal and the CA-125 blood test is negative but the mass is greater than 1.2 inches (3 cm), laparoscopic surgery will be performed to inspect the mass and determine whether it is benign or malignant. When the postmenopausal woman has an elevated CA-125 serum level, an abnormal Papanicolaou smear, and the mass does not look cyst-like, laparoscopic surgery will be performed to remove the mass and ovaries and review the uterine area.

Uterine cysts may cause excessive menstrual bleeding.
Uterine cysts may cause excessive menstrual bleeding.

Whenever a malignancy is found, the mass will be removed along with most of or all of the reproductive organs and lymph nodes in the area. All of these structures will be reviewed pathologically to determine the extent of the cancer. The pathology results will determine the chemotherapy ordered following surgery. Benign masses will be removed along with the ovaries, and a thorough review of the area will look for any other masses.

Discussion Comments

anon348984

An ultrasound showed that I have a 2.6 x 2.2 cm adnexal cystic mass in my right ovary. What does this mean?

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    • Following surgery for an adnexal mass, the patient may undergo chemotherapy treatments.
      By: tawesit
      Following surgery for an adnexal mass, the patient may undergo chemotherapy treatments.
    • Adnexal masses occur in and around the uterus.
      By: blueringmedia
      Adnexal masses occur in and around the uterus.
    • A large adnexal mass is reviewed and removed using laparoscopic surgery.
      By: Grzegorz Kwolek
      A large adnexal mass is reviewed and removed using laparoscopic surgery.
    • If a postmenopausal woman has an adnexal mass, a complete gynecological exam will be performed.
      By: endostock
      If a postmenopausal woman has an adnexal mass, a complete gynecological exam will be performed.
    • Uterine cysts may cause excessive menstrual bleeding.
      By: Vlad Ivantcov
      Uterine cysts may cause excessive menstrual bleeding.