OBJECTIVE: To investigate risks of torsion and malignancy by adnexal mass size during pregnancy. DESIGN: Retrospective review of medical records. SETTING: General university hospital and healthcare center. POPULATION: Four hundred and seventy women who underwent surgery for adnexal masses during pregnancy between 2002 and 2009. MAIN OUTCOME MEASURES: Rate of torsion and malignancy according to mass size classified into four groups: <6, 6-10, 10-15 and ≥15 cm. RESULTS: Torsion was encountered in 55 patients (11.7%) and malignancy was confirmed in 20 (4.3%). A mass size of 6-10 cm had a significantly higher risk of torsion than a mass <6 cm (odds ratio 2.68, 95% confidence interval 1.33-5.40, p=0.006). Masses ≥15 cm had an approximately 12-fold higher risk of malignancy compared with masses <6 cm (odds ratio 12.36, 95% confidence interval 2.90-52.67, p=0.001). However, for masses of 10-15 cm, the risks of both torsion and malignancy were not higher than those of masses <6 cm. CONCLUSIONS: Risks of torsion and malignancy are not directly proportional to increasing mass size in pregnant women. Physicians should be aware of a high risk of malignancy in women with an adnexal mass of over 15 cm. However, if a mass is smaller, the size should not be considered as a single independent factor in a decision for surgery.
OBJECTIVE: To investigate risks of torsion and malignancy by adnexal mass size during pregnancy. DESIGN: Retrospective review of medical records. SETTING: General university hospital and healthcare center. POPULATION: Four hundred and seventy women who underwent surgery for adnexal masses during pregnancy between 2002 and 2009. MAIN OUTCOME MEASURES: Rate of torsion and malignancy according to mass size classified into four groups: <6, 6-10, 10-15 and ≥15 cm. RESULTS: Torsion was encountered in 55 patients (11.7%) and malignancy was confirmed in 20 (4.3%). A mass size of 6-10 cm had a significantly higher risk of torsion than a mass <6 cm (odds ratio 2.68, 95% confidence interval 1.33-5.40, p=0.006). Masses ≥15 cm had an approximately 12-fold higher risk of malignancy compared with masses <6 cm (odds ratio 12.36, 95% confidence interval 2.90-52.67, p=0.001). However, for masses of 10-15 cm, the risks of both torsion and malignancy were not higher than those of masses <6 cm. CONCLUSIONS: Risks of torsion and malignancy are not directly proportional to increasing mass size in pregnant women. Physicians should be aware of a high risk of malignancy in women with an adnexal mass of over 15 cm. However, if a mass is smaller, the size should not be considered as a single independent factor in a decision for surgery.
Authors: E Ball; N Waters; N Cooper; C Talati; R Mallick; S Rabas; A Mukherjee; Y Sri Ranjan; M Thaha; R Doodia; R Keedwell; M Madhra; N Kuruba; R Malhas; E Gaughan; K Tompsett; H Gibson; H Wright; C Gnanachandran; T Hookaway; C Baker; K Murali; D Jurkovic; N Amso; J Clark; S Thangaratinam; T Chalhoub; P Kaloo; E Saridogan Journal: Facts Views Vis Obgyn Date: 2019-03