Tubo-ovarian abscesses in postmenopausal women: gynecological malignancy until proven otherwise?

Objective: To investigate the incidence of gynecological malignancy in menopausal women who develop tubo-ovarian abscesses (TOAs), and to address the differences in presentation and underlying pathology between premenopausal and postmenopausal women with TOAs. Study design: In a retrospective study...

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Published in:	European journal of obstetrics & gynecology and reproductive biology Vol. 114; no. 2; pp. 203 - 209
Main Authors:	Protopapas, Athanasios G, Diakomanolis, Emmanuel S, Milingos, Spyros D, Rodolakis, Alexandros J, Markaki, Sophia N, Vlachos, Georgios D, Papadopoulos, Dimitrios E, Michalas, Stylianos P
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 15-06-2004 Elsevier
Subjects:	Abdominal Pain Abscess - complications Abscess - diagnosis Adolescent Adult Aged Biological and medical sciences Fallopian Tube Diseases - complications Fallopian Tube Diseases - diagnosis Fallopian Tube Diseases - surgery False Negative Reactions Female Fever Genital Neoplasms, Female - complications Genital Neoplasms, Female - diagnosis Genital Neoplasms, Female - surgery Gynecology. Andrology. Obstetrics Humans Laparoscopy Medical sciences Menopause Middle Aged Ovarian Diseases - complications Ovarian Diseases - diagnosis Ovarian Diseases - surgery Pelvic infections Postmenopause Premenopause Tomography, X-Ray Computed Tubo-ovarian abscess Ultrasonography Urogenital neoplasms Urogenital neoplasms Pelvic infections Menopause Tubo-ovarian abscess Human Gynecology Abscess Malignancy Malignant tumor Obstetrics Urogenital Infection Ovary Pelvic cavity Female genital system Postmenopause Female
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Summary:	Objective: To investigate the incidence of gynecological malignancy in menopausal women who develop tubo-ovarian abscesses (TOAs), and to address the differences in presentation and underlying pathology between premenopausal and postmenopausal women with TOAs. Study design: In a retrospective study we included 93 patients with a diagnosis of a TOA and compared a premenopausal group (group 1) with a postmenopausal group (group 2). Results: Group 1 included 76 (82%), and group 2 17 (18%) patients. Abdominal pain and pyrexia >38 °C were present in 93 and 74% cases of group 1, and in 71 and 41% cases of group 2 ( P=0.016 and 0.019, respectively). Irregular vaginal bleeding and gross ascites were significantly more frequent in group 2. With respect to benign additional pathology we found no differences between the two groups. On the contrary a significant association between TOAs in menopause and malignancy was established. In 8 (47%) postmenopausal cases a concomitant gynecological malignancy was found including a variety of cancers. Conclusion: Postmenopausal women presenting with TOAs, should be thoroughly investigated to exclude a concomitant pelvic malignancy. Conservative treatment of TOAs has no place during the menopause.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0301-2115 1872-7654
DOI:	10.1016/j.ejogrb.2003.10.032