Conservative Management of Asymptomatic Adnexal Masses Classified as Benign by the IOTA ADNEX Model: A Prospective Multicenter Portuguese Study

This prospective multicentric study aiming to determine the incidence of complications (malignant transformation, torsion or rupture) during conservative management of adnexal masses was performed in two Portuguese tertiary referral hospitals. It included ≥18-year-old, non-pregnant patients with asy...

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Bibliographic Details
Published in:Diagnostics (Basel) 2021-10, Vol.11 (11), p.1992
Main Authors: Brito, Marta Espanhol, Borges, André, Rodrigues, Sofia, Ambrósio, Paula, Condeço, Raquel, Lacerda, Abílio, Bernardo, Maria José, Pinto, Patrícia, Djokovic, Dusan
Format: Article
Language:English
Subjects:
Abdomen
adnexal mass
Asymptomatic
benign lesions
conservative management
Cysts
Gynecology
Histology
Hospitals
IOTA ADNEX model
Morphology
Mortality
Ovarian cancer
Patients
Surgery
Tumors
Ultrasonic imaging
ultrasound
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Summary:This prospective multicentric study aiming to determine the incidence of complications (malignant transformation, torsion or rupture) during conservative management of adnexal masses was performed in two Portuguese tertiary referral hospitals. It included ≥18-year-old, non-pregnant patients with asymptomatic adnexal masses (associated IOTA ADNEX risk of malignancy < 10%) sonographically diagnosed between January 2016 and December 2020. Conservative patient management consisted of serial clinical and ultrasound assessment up to 60 months of follow-up, spontaneous resolution of the formation or surgical excision (median follow-up: 17.8; range 9–48 months). From the 573 masses monitored (328 premenopausal and 245 postmenopausal adnexal masses), no complications were observed in 99.5%. The annual lesion growth rates and increases in morphological complexity were similar in the premenopausal and postmenopausal patients. Spontaneous resolution, evidenced in 16.4% of the patients, was more common in the premenopausal group (p < 0.05). Surgical intervention was performed in 18.4% of the cases; one borderline and one invasive FIGO IA stage cancer were diagnosed. There was an isolated case of ovary torsion (0.17%). These data support conservative management as a safe option for sonographically benign, stable and asymptomatic adnexal masses before and after menopause and highlight the need for expedite treatment of symptomatic or increased-morphological-complexity lesions.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics11111992