Sonographic Evaluation Of Female Pelvic Adnexal Lesions In Reproductive Age Group:A Cross-Sectional Observational Study

Background: Pelvic adnexal lesions are commonly encountered in women of reproductive age and encompass a wide spectrum of benign and malignant pathologies. Early and accurate differentiation between benign and malignant adnexal masses is crucial for appropriate patient management. Ultrasonography, particularly with the application of standardized scoring systems such as the International Ovarian Tumor Analysis (IOTA) simple rules, plays a pivotal role in the evaluation of these lesions. Aim: To evaluate the sonographic characteristics of female pelvic adnexal lesions in the reproductive age group and to assess the diagnostic utility of ultrasonography using IOTA simple rules with histopathological correlation wherever available. Materials and Methods: This cross-sectional observational study included 97 female patients aged 15–50 years presenting with clinically suspected adnexal lesions. All patients underwent transabdominal and transvaginal ultrasonography with grayscale and color Doppler evaluation. Lesions were assessed for morphological features and vascularity, and categorized using IOTA simple rules. Histopathological correlation was performed in surgically managed cases. Results: The mean age of patients was 33.67 years, with the majority belonging to the 20–40 year age group. Lower abdominal pain was the most common presenting complaint (93.8%). On ultrasonography, simple ovarian cysts (45.4%) and hemorrhagic cysts (29.9%) were the most frequent lesions. According to IOTA classification, 87.6% of lesions were benign, 2.1% borderline, and 10.3% malignant. Malignant lesions constituted 6.2% on ultrasonography, with epithelial ovarian tumors being the most common on histopathology. Serous cystadenocarcinoma was the predominant malignant subtype. Conclusion: Most adnexal lesions in women of reproductive age are benign. Ultrasonography combined with IOTA simple rules is a reliable, non-invasive tool for differentiating benign and malignant adnexal lesions, thereby aiding in appropriate clinical decision-making and management.