Adnexal tumours in reproductive period and after menopause

Aim of study : 1. Comparison of the frequency of pathological adnexal masses in the groups of women at reproductive and menopausal age; 2. evaluation of the type and extent of operative procedures regarding patients’ age.

Material and methods : The study group – 285 women, hospitalized in the Department of Gynaecology and Menopausal Diseases in Polish Mother’s Memorial Hospital, Research Institute, in whom adnexal tumours were operated and histologically tested. Two subgroups of patients were then distinguished – G1 (n = 92) – patients below 45 years of age (17 – 44.9 years) and G2 (n = 193) – patients older than 45 years of age (45 – 88 years). The crucial role in the diagnostic process was played by transvaginal ultrasound (TVU), being a basis for preliminary diagnosis.

Results : Malignant ovarian neoplasms were detected in G1 and G2 with the frequency of 2.1% and 17.6% respectively, benign neoplasms in 42.3% and 36.3%, and non-neoplastic lesions in 54.3% and 45% of women. In G2 metastatic neoplasms constituted 26.5% of malignant tumours, while from 2 cases of cancer in G1 none was of metastatic character. Among benign neoplasms in both groups teratomas were predominant, being especially frequent in G1 – 82% of benign neoplasms (in G2 – 35.7%). However, among non-neoplastic lesions in G1 functional cysts and endometriosis were observed with the same frequency (42%), but in G2 functional cysts prevailed – 71.2%. In G1 laparoscopy was performed in 39.1% of patients, and the most frequent procedures were various preservative ovarian operations – 36.9%; in G2 laparoscopy was performed rarely, in 14% of patients, while in this group hysterectomy with bilateral adnexectomy was performed mostly (38.8%).

Conclusions : 1. Adnexal tumours of women at reproductive age, in comparison to adnexal tumours of menopausal women, are characterized by a lower frequency of malignant neoplasms and a higher percentage of benign neoplasms and non-neoplastic lesions. 2. Patient’s age still remains one of the main factors influencing decisions concerning the type and extent of adnexal tumour treatment. 3. TVU is an effective diagnostic tool of pathological adnexal lesions allowing one to obtain high coincidence of preliminary diagnoses with final postoperative diagnoses.