ADENEXAL CYSTS

(1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neithersimple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these casesaccording to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: MedlineStudy Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics andGynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented withadnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD.Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence ofmalignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed bymenstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73%masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts withpapillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy.Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40%patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cystswere the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants.Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential indetermining risk of malignancy and may be advantageous in terms of counseling patients for management.