Management of the adnexal mass in the 1990s.

BACKGROUND: Ovarian carcinoma is the leading cause of deaths from female genital cancers in the United States. During the last three decades, advances in diagnostic techniques, surgical techniques, and adjuvant chemotherapy have led to improved survival in some patients who have an adnexal mass that is later diagnosed as malignant.
METHODS: A review of the current technique, compiled with our changing management, was done to help identify possible pitfalls in the initial management of the adnexal mass in specific age groups. The expensive and controversial issues such as screening, management of patients with a genetic history, and management with laparoscopy were reviewed.
RESULTS: Appropriate initial surgery improves survival in patients with adnexal masses, later determined to be malignant, particularly when adjuvant, modern combination chemotherapy is used. Laparoscopy for suspicious adnexal masses cannot be condoned, unless immediate appropriate surgical staging can be done.
CONCLUSIONS: Awareness and implementation of current diagnostic and treatment modalities can improve survival in the patient with an adnexal mass that is later found to be malignant.