Diagnosis of adnexal mass in our clinic operated under 35 years retrospective analysis of the cases

Aim: İnspect diagnosis methods which are using in benign-malign determination of adnexal masses in adolescent and early reproductive stage and to investigate surgical approach.Material and method: Between February 2000 and November 2010, 630 patients data who underwent surgery for adnexal masses in Dicle University Faculty of Medicine Dept. of Gynecology Clinic, ages 35 years and under, were inspected retrospectively. K square and t-test were used for statistical analysis. p<0.05 were accepted as statistically significant.Results: According to histopathological results, benign 554(%87,9), borderline 18 (%2,8) and malign 54 (%9,2) respectively. Before the surgery, when benign group were compared to malign group, although demographics features such as age, pregnancy and number of birth were not statistically different, cyst rupture and assist rates which were evaluated by clinical and ultrasound examinations were significantly different (p<0.05) between groups. Furthermore, average values for CA125, CA15-3, CEA, CA19-9, AFP in benign group were lower than malign group (p<0.05). Observed benign histopathological masses were mature cystic teratoma (184 case, 33,2 %), endometrioma (132 case, 23,8%) serous cyst adenoma(90 case, 16.2%) in all age groups. The most frequently type of malign tumor was germ cell tumor (12 olgu,%70,5 ) and epithelial tumor (31 olgu,%56,3) for under the age of 21 group and above the age of 21 group respectively. Among malign masses , 22 cases (%44), 3 cases (6%), 14 cases (28%) and 11 cases (22%) were stage I, stage II, stage III and stage IV respectively. According to the applied surgery, the most common type of surgery was cyst / mass extirpation (70.32%), the second was USO (17.78%), the third was the staging surgery (4.44%).Conclusion: Diagnostic methods which used preoperative differentiation of benign and malignant adnexal masses is not enough alone. Although ovarian tumors seen rarely during childhood and adolescence but it is the most common genital tumors for this age group. Because of higher malignant potential in young patients and also have effect on future fertility, detailed clinical and pathologic evaluation should be conducted in the presence of an adnexal mass.Key words: adnexal mass, malignancy, surgical approach