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Purpose: To assess what clinical and ultrasound features could be most helpful for discriminating benign from malignant unilocular cysts with solid components in premenopausal women with no signs of ascites or carcinomatosis. Materials and methods: Retrospective study comprising 91 women with preoperative diagnosis of unilocular-solid cyst that underwent surgical removal. The following variables were assessed: age, complaints at presentation, bilaterality, mean size of the lesion, number of papillary projections, size of solid com ponent, surface of solid component (smooth or irregular), amount of color within solid component (no flow, minimal flow, moderate flow, abundant flow). Definitive histopathological diagnosis was used as gold standard. Multivariate logistic regres sion analysis was performed to identify which variables were independent predictors of malignancy and their odds ratios (OR). Results: Malignant lesions had significantly larger tumor size, more number of solid components, larger size of solid component, more frequency of irregular surface in the solid component and more frequent moderate or abundant vascularization within the solid component. Logistic regression analysis identified amount of color (OR: 48.7), solid component’s surface (OR: 29.1) and mean size of the lesion (OR: 1.58) as independent predictors for malignancy. Conclusion: Tumor size, irregular surface and the presence of moderate or abundant color score within the solid component are the features more frequently associated to malignancy in unilocular-solid adnexal cysts in premenopausal women.

donald school journal of ultrasound in obstetrics and gynecology

Ultrasound Features for Determining the Risk of Malignancy in Unilocular-Solid Adnexal Masses in Premenopausal Women without Ascites and/or Carcinomatosis