OC03.04: Conservative management of adnexal masses classified as benign by IOTA ADNEX model: a prospective study
Year: 2020
Type: conference-abstract
Abstract: We aimed to determine the incidence of complications during the follow-up of adnexal masses classified as benign by the IOTA ADNEX model, in asymptomatic pre- and postmenopausal women. A prospective study was performed between October 2016 and April 2020 at two Portuguese tertiary referral hospitals. We included 484 asymptomatic, ≥18-year-old women, diagnosed with at least one adnexal mass classified as benign by the IOTA ADNEX model. Conservative management included ultrasound and clinical follow-up at intervals of 3 months and 6 months, and then every 12 months thereafter until spontaneous resolution or surgical excision. The follow-up is currently being held. 569 adnexal masses were analysed, 59,2% (n = 337) from premenopausal and 40,8% (n = 232) from postmenopausal women. There were no acute complications reported such as rupture or torsion. Eighty-two (14,4%) of the adnexal masses had a spontaneous resolution, 70 (12,3%) increased in size and 25 (4,4%) increased in morphologic complexity. 78 masses were surgically removed; from these, two were proved to be malignant (0,35%). One was a postmenopausal woman with changes in the morphologic complexity at the third evaluation suggesting a borderline tumour, which was confirmed at histologic examination. The other was a premenopausal woman with de novo symptoms and an increase in size and morphologic complexity of the initial mass who proved to have a primary ovarian cancer (mucinous type, FIGO stage IA). Our results are in accordance with the current literature suggesting that the risk of malignancy is very low when adnexal pathology presents with benign ultrasound features. In contrast, the onset of symptoms and/or increase in the ultrasound complexity of the lesion should be promptly addressed. These data favor conservative management in patients diagnosed with benign longstanding stable adnexal masses according to the IOTA ADNEX model.
DOI: 10.1002/uog.22217
Authors: M.E. Brito, P. Pinto, S. Rodrigues, A. Borges, J. Aquino, P. Ambrósio, R. Condeço, D. Djokovic, M.D Bernardo, A. Lacerda
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3154315040