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OP03.06: Characteristics of conservatively managed ovarian masses
Author(s) -
Erdodi B.,
Torok F.,
Szanto L.,
Jakab A.
Publication year - 2019
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.20673
Subject(s) - medicine , malignancy , conservative management , cyst , radiology , gynecology , surgery
Methods: In a prospective setting 81 patients (Mean: 49.4yrs (14-84), SD: 17.91yrs) had IOTA based ultrasound scan during a 25 months follow-up interval (February, 2017-March, 2019). Both ovarian specific tumor markers (CA125, HE4 and ROMA score) and IOTA models have been checked. Results: Average appearances by patients: 1.91 (1-5), Mean follow-up time: 5.75 months. Spontaneous resolution of the cyst have been noticed in 23.5%. Majority of the tumors were unilocular (53.8%), multilocular (29.3%) and multilocular-solid (7.2%). The cyst content was anechoic (51.25%), low-level (23.3.%) and hemorrhagic (12.8%). Most tumors had regular walls (90.8%). Surprisingly nearly one-third of the tumors showed at least minimal color score and abundant flow was also noticed in 5.9% of the cases. Tumor markers have been used only as adjacent diagnostic tools, no therapeutic decision was made based only on these values. Both averages of CA125 (23.42 (4.3-162.3), SD: 23.51) and HE4: 56.75 (11.7-135.6), SD: 26.88) were in normal range but the variability was high. Average ADNEX score was 4.87% (0.1-69.6), SD: 10.29. During the follow-up period one case has been operated: Morphological transformation by subjective assessment (ADNEX model has not indicated higher risk) showed high risk for malignancy and turned to be a malignant Brenner tumor. Conclusions: Conservative management based on IOTA rules and models can be a reliable tool for both experts and non-experienced examiners. Not only simple cysts can be candidate for conservative treatment however regular checkups using the same tools are necessary for selecting cases calling for surgery. Unilocular 54%