Adnexal Masses

Adnexal masses are abnormal growths that develop on the adnexa of the uterus, which includes the ovaries, fallopian tubes, and surrounding tissues. These masses can be benign (non-cancerous) or malignant (cancerous) and can cause a range of symptoms, from mild discomfort to severe pain.

Causes and Risk Factors

Adnexal masses can be caused by a variety of factors, including:

• Hormonal changes during the menstrual cycle
• Ovulation disorders
• Infections, such as pelvic inflammatory disease (PID)
• Cysts or tumors on the ovaries or fallopian tubes
• Endometriosis, a condition in which tissue similar to the lining of the uterus grows outside the uterus

Symptoms

The symptoms of adnexal masses can vary depending on the size and location of the mass, as well as whether it is benign or malignant. Common symptoms include:

• Pelvic pain or discomfort
• Bloating or swelling in the abdomen
• Abnormal vaginal bleeding or discharge
• Difficulty urinating or having bowel movements
• Feeling of fullness or pressure in the pelvis

Diagnosis

Adnexal masses are typically diagnosed using a combination of physical examination, medical history, and imaging tests, such as:

• Pelvic exam
• Ultrasound
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Ca-125 blood test, which can help identify ovarian cancer

Treatment

The treatment for adnexal masses depends on the size and location of the mass, as well as whether it is benign or malignant. Treatment options may include:

• Watchful waiting, in which the mass is monitored with regular ultrasound exams to see if it grows or changes
• Surgery, such as laparoscopy or laparotomy, to remove the mass and surrounding tissue
• Hormonal therapy, such as birth control pills, to help shrink the mass
• Chemotherapy or radiation therapy, if the mass is cancerous

Complications

If left untreated, adnexal masses can cause a range of complications, including:

• Ovarian torsion, in which the ovary twists around its blood supply, cutting off blood flow
• Rupture of the mass, which can lead to severe bleeding and infection
• Malignant transformation, in which a benign mass becomes cancerous
• Infertility or difficulty getting pregnant

Prevention

While it is not possible to prevent all adnexal masses, there are steps that can be taken to reduce the risk of developing them, such as:

• Practicing safe sex to reduce the risk of PID and other infections
• Getting regular pelvic exams and Pap tests
• Maintaining a healthy weight and diet
• Avoiding tobacco and excessive alcohol use