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Federación Mexicana de Ginecología y Obstetricia, A.C.

2010, Number 03

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Ginecol Obstet Mex 2010; 78 (03)

Adnexal tumor and pregnancy: diagnosis and treatment

Arteaga-Gómez AC, Aranda-Flores C, Márquez-Acosta G, Colín-Valenzuela A

Language: Spanish
References: 23
Page: 160-167
PDF size: 349.29 Kb.


ABSTRACT

Background: The finding of adnexal masses during pregnancy is an exceptional event. Its reported incidence is less than 5% and most cases resolve spontaneously as the pregnancy progresses.
Objective: Describe a case series of patients with adnexal mass and pregnancy.
Material and methods: We retrospectively reviewed the medical records of patients who had diagnosis of pregnancy and adnexal over a period of five years.
Results: The incidence was 0.22%. The mean age was 26 ± 7.3 years, mean gestational age was 17 ± 6.6 weeks. The diagnosis was established by ultrasound (USG) in 95% of cases, 48% had cystic characteristics, the mean diameter of the tumor was 99 ± 42 mm. Cistectomy was performed during pregnancy or trans-cesarean section in 30% and 58% of patients respectably. The mean tumor size was 118 mm (range 2 a 40 mm), weight 1,370 g (range 10 a 5,800 g). The most frequent histological diagnosis were serous cyst (40%), mature teratoma (28%), mucinous (6%), malignancy (4%). There were not complications related to the surgical procedure.
Conclusions: The USG constitute a safe method for the diagnosis, but the image method with the highest positive predictive value is the MRI. Tumor markers (CA-125, AFP, GCH-B,DHL, ACE), are not useful during pregnancy. If the tumor doesn’t achieve surgical criteria the recommended follow up is clinical observation and USG. If surgery is decided, it should be performed between 16 a 23 weeks of pregnancy, and it’s recommended to send the tumor to histological diagnosis, in case of malignancy the surgery will continue according to the tumor stage. The time and delivery route will be decided by the obstetrician.


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