Adnexal Masses: The Good, the Bad, and the Ugly

The common adnexal masses include lesions of infectious or occlusive origin such as hydrosalpinx and tubo-ovarian abscess (either primary pelvic cause or secondary to gastrointestinal disease), functional cysts and endometriomas, and benign or malignant neoplasms. From a practical standpoint, the colorectal surgeon is most likely to encounter these masses unexpectedly at the time of surgery for gastrointestinal disease and will be faced with intraoperative management. Fortunately, approximately 15 entities account for 98.5% of all neoplastic (benign, borderline, and malignant) masses found at the time of surgery or workup of abdominal or colorectal disease.

Adnexal masses - hydrosalpinx - tubo-ovarian abscess - ovarian mass - ovarian cyst - endometriomas

- 1 Scully R E, Young R H, Clement P B. Tumors of the Ovary, Maldeveloped Gonads, Fallopian Tube, and Broad Ligament. Fascicle 23. Washington, DC: Armed Forces Institute of Pathology 1998 - 2 Schmahmann S, Haller J. Neonatal ovarian cysts: pathogenesis, diagnosis and management. Pediatr Radiol . 1997; 27 101-105 - 3 DiSaia P J, Creasman W T. Clinical Gynecologic Oncology, 5th ed. St. Louis, MO: Mosby-Yearbook 1995 - 4 Sciarra J J. Gynecology and Obstetrics. vols. 1 and 5. Hagerstown, MD: Lippincott Williams & Wilkins; 2002 - 5 Dolgin S. Ovarian masses in the newborn. Semin Pediatr Surg . 2000; 9 121-127 - 6 Lovvorn III N H, Tucci L A, Stafford P W. Ovarian masses in the pediatric patient. Association of Operating Room Nurses J . 1998; 67 568-576 - 7 Kozlowski K. Ovarian masses. Adolesc Med . 1999; 10 337-350 - 8 Pinkerton C R. Malignant germ cell tumors in childhood. Eur J Cancer . 1997; 33 895-902 - 9 Helmrath M, Shin C, Warner B. Ovarian cysts in the pediatric population. Semin Pediatr Surg . 1998; 7 19-28 - 10 Robboy S J, Anderson M D, Russell P. Pathology of the Female Reproductive Tract. London: Churchill Livingston 2002 - 11 Abu-Rustum N R, Barakat R R, Curtin J P. Ovarian and uterine disease in women with colorectal cancer. Obstet Gynecol . 1997; 89 85-87 - 12 Clement P B, Young R H. Atlas of Gynecologic Surgical Pathology. Philadelphia, PA: W.B. Saunders 2002 - 13 Drake J. Diagnosis and management of the adnexal mass. Am Fam Physician [online] 1998 May [cited 2002 Sept 10]. Available from URL: www.aafp.org/afp/980515ap/drake.html