Clinico-Pathological Evaluation of Adnexal Masses among Patients Attending to Tertiary Care Centre

Abstract

Background: Adnexal masses are commonly encountered in gynaecological practice and may arise from ovarian, tubal, or surrounding structures. While most are benign, a significant proportion may be malignant, necessitating accurate diagnosis for appropriate management. This study aimed to evaluate adnexal masses using clinical, biochemical, radiological, and histopathological parameters and to differentiate between functional, benign, and malignant lesions.

Methods: A prospective observational study was conducted over 18 months among 106 women admitted with suspected adnexal masses in a tertiary care hospital. Patients with ectopic pregnancy and uterine masses were excluded. Data were collected through clinical evaluation, laboratory investigations including tumor markers (CA-125), imaging (ultrasound/MRI), and histopathological examination. Statistical analysis was performed using SPSS version 20, applying descriptive and inferential statistics with significance set at p<0.05.

Results: The mean age was 44.75±9.65 years, with most patients in the 41–50-year group. The commonest symptom was abdominal pain (64.1%), followed by abnormal uterine bleeding (26.4%). Ovarian origin accounted for 80.2% of masses, with 84.9% being unilateral. Most lesions were benign (82.1%), while 17.9% were malignant. Among ovarian tumors, benign lesions constituted 60%, malignant 21.2%, and non-neoplastic 18.8%. Mucinous cystadenoma was the most common benign tumor, and serous cystadenocarcinoma the most common malignant tumor. Malignancy was significantly associated with increasing age, menopausal status, irregular menstrual cycles, elevated CA-125 levels, and higher Risk Malignancy Index scores (p<0.001).

Conclusions: Adnexal masses are predominantly benign, with ovarian origin being most common. Clinical features combined with CA-125 and RMI are valuable in predicting malignancy. Early and accurate evaluation is essential for optimal management and improved outcomes.