Adnexal masses in pregnancy: an updated review on diagnosis and treatment

• Published in: Tumori Vol. 107; no. 1; pp. 12 - 16
• Main Authors: D’Ambrosio, Valentina, Brunelli, Roberto, Musacchio, Lucia, Del Negro, Valentina, Vena, Flaminia, Boccuzzi, Gaia, Boccherini, Chiara, Di Donato, Violante, Piccioni, Maria Grazia, Benedetti Panici, Pierluigi, Giancotti, Antonella
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-02-2021
• Subjects: Adnexal Diseases - diagnosis; Adnexal Diseases - diagnostic imaging; Adnexal Diseases - pathology; Adnexal Diseases - surgery; Adult; Female; Humans; Laparoscopy; Laparotomy; Magnetic Resonance Imaging; Neoplasms - diagnosis; Neoplasms - diagnostic imaging; Neoplasms - pathology; Neoplasms - surgery; Pelvic Neoplasms - diagnosis; Pelvic Neoplasms - diagnostic imaging; Pelvic Neoplasms - pathology; Pelvic Neoplasms - surgery; Pregnancy; Pregnancy Complications, Neoplastic - diagnosis; Pregnancy Complications, Neoplastic - diagnostic imaging; Pregnancy Complications, Neoplastic - pathology; Pregnancy Complications, Neoplastic - surgery; ultrasound examination; Adnexal masses; MRI; laparoscopic surgery; pregnancy; laparotomic surgery
• ISSN: 0300-8916; 2038-2529
• DOI: 10.1177/0300891620909144

Adnexal masses are not common in pregnancy. They are often discovered incidentally during routine ultrasound examinations. In general, 24%–40% of the cases are benign tumors; up to 8% are malignant tumors. Adnexal masses are usually asymptomatic, but sometimes can be responsible for abdominal or pelvic pain. Transvaginal and transabdominal ultrasound is essential to define the morphology of pelvic masses and to distinguish between benign and malignant cases. Magnetic resonance imaging can be a complementary examination when ultrasound findings are equivocal and a useful additional examination to better define tissue planes and relations with other organs. Patient counseling can be challenging because there is no clear consensus on the management of adnexal masses during pregnancy. Treatment options consist of observational management (in case of asymptomatic women with reassuring instrumental findings) or surgery (via laparoscopy or laparotomy). Surgery can be offered as a primary tool when cancer is suspected or when acute complications such as ovarian torsion occur.