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The value of detection of normal ovarian tissue (the ‘ovarian crescent sign’) in the differential diagnosis of adnexal masses
Author(s) -
Hillaby K.,
Aslam N.,
Salim R.,
Lawrence A.,
Raju K. S.,
Jurkovic D.
Publication year - 2004
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.946
Subject(s) - medicine , adnexal mass , differential diagnosis , ovarian cancer , malignancy , ovarian cyst , ovary , ovarian tumor , adnexal diseases , radiology , cyst , ultrasound , pathology , cancer , laparoscopy
Objective The aim of the study was to evaluate whether the presence of normal ovarian tissue adjacent to an adnexal tumor (the ‘ovarian crescent sign’) could assist in the preoperative differential diagnosis of adnexal lesions. Methods This was a prospective observational study including 100 women with a preoperative diagnosis of an adnexal mass. Demographic and biochemical data were collected and all women underwent a detailed transvaginal ultrasound scan. Tumor volume, morphological characteristics and Doppler features were recorded in each case. In addition, the tissue adjacent to the cyst was systematically examined for the presence of normal ovarian tissue. All the findings were compared to the final histological diagnosis. Results Sixty‐seven (67%) of the cysts removed were benign, nine (9%) were borderline and 24 (24%) women had invasive malignant lesions. Normal ovarian tissue was seen in 58/76 (76%) women with non‐invasive lesions, and in one woman (4%) with an invasive malignancy. In the absence of normal ovarian tissue, ovarian cancer was diagnosed with a sensitivity of 96% and specificity of 76%. Conclusion The presence of normal ovarian tissue adjacent to an ovarian cyst is a useful morphological feature that may be used to help exclude an invasive ovarian malignancy in women with adnexal masses detected on ultrasound scan. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.