Abstract
BACKGROUND: The prevalence of adnexal masses is 0.17% to 5.9% in asymptomatic and 7.1% to 12% in symptomatic patients. They can be benign or malignant. The initial detection and evaluation of an adnexal mass requires a high index of suspicion, a thorough history and examination and careful attention to subtle historical clues. Timely appropriate laboratory studies like serum cancer markers and radiographic studies are required to make a diagnosis, and finally, histopathological report tells us the exact nature of mass and guides further management. METHODOLOGY: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, SMGS Hospital, GMC Jammu, over a period of one year from August 1st, 2023 to July 31st, 2024. The aim of this study was to determine the prevalence of adnexal masses with their related factors in this age group and to evaluate the adnexal mass in perimenopausal and postmenopausal age group. A total of 100 patients of adnexal masses with age > 40 years meeting inclusion and exclusion were included in the study. From all patients, history was obtained, clinical examination done followed by blood analysis, tumor markers, ultrasonography findings, CT and MRI findings of pelvic organs wherever applicable was done. Histopathological report was obtained. RESULTS: Adnexal mass was found to be more common in age group 40-50 years (48%). The usual presentation was with symptoms of abdominal pain (76%). Left-sided ovarian mass (41%) was more common than right-sided (32%) or bilateral masses (13%). USG 1 score was reported mostly in subjects with benign mass (67 out of 71), while USG 4 score was reported maximum among malignant mass (19 out of 29). CA-125 < 35 level was reported maximum among benign mass (68 out of 72), while > 35 level of CA-125 was reported maximum among malignant mass (19 out of 28). RMI < 200 was found mostly among benign mass (77 out of 79), while RMI > 200 was reported maximum in malignant mass (21 out of 21). In our study, each parameter when compared with histopathological report using kappa stats, results were found to be statistically significant (p < 0.05). Benign masses were present in 64.2% cases and malignant masses were present in 35.8% cases in perimenopausal age group and 33.3% benign and 66.7% malignant cases were present in postmenopausal age group. CONCLUSION: Ultrasound and CA-125 are important adjuvants which play vital role in the diagnosis and treatment of adnexal masses in perimenopausal and post-menopausal women. RMI and histopathology findings are in positive correlation. Therefore, it can be concluded that RMI can be used for evaluation of adnexal mass preoperatively and thus guides further management.