Physical examination

A. Palpation of an asymptomatic adnexal mass during a routine pelvic examination is the usual presentation for ovarian cancer. The presence of a solid, irregular, fixed pelvic mass on pelvic examination is highly suggestive of an ovarian malignancy. However, endometriomas and tubo-ovarian abscesses are benign tumors that may be fixed, while cystadenofibromas and tubo-ovarian abscesses are benign masses that feel irregular. The diagnosis of malignancy is almost certain if a fixed, irregular pelvic mass is associated with an upper abdominal mass or ascites.

Differential Diagnosis of Adnexal Masses in Women

Extraovarian mass Ectopic pregnancy Hydosalpinx or tuboovarian abscess Paraovarian cyst Peritoneal inclusion cyst

Pedunculated fibroid Diverticular abscess Appendiceal abscess

Ovarian mass Simple or hemorrhagic physiologic cysts (eg, follicular, corpus luteum) Endometrioma

Theca lutein cysts Benign or malignant neoplasms (eg, epithelial, germ cell, sex-cord) Metastatic carcinoma (eg, breast, colon, endometrium)

0 0

Post a comment