Management of adnexal cystic masses with unexpected intracystic vegetations detected during laparoscopy
Received 22 March 2005; accepted 14 July 2005.
Abstract
Study objective
To evaluate a prospective series of consecutive patients with unexpected intracystic vegetations detected during operative laparoscopy for adnexal masses.
Design
Prospective series of consecutive patients (Canadian Task Force classification: II-2).
Setting
Tertiary care university hospitals.
Patients
Consecutive patients found during surgery to have unexpected intracystic vegetations and treated by operative laparoscopy, out of a total series of 667 patients under 40 years of age with ultrasonographic evidence of an adnexal cystic mass without thick septa, internal wall papillarities, or solid components.
Interventions
Operative laparoscopy and follow-up.
Measurements and main results
Thirty-five (5.2%) of 667 patients were found at surgery to have unexpected intracystic vegetations. A frozen section was sent for pathologic analysis in all 35 patients. Frozen section diagnosis was benign in 32 patients and borderline in 3 patients. Final pathology diagnosis was borderline ovarian tumor in five of the 35 patients (14.3%), and benign in 30 patients (85.7%). No case of invasive carcinoma was diagnosed either at frozen section or at final pathology examination. The patients with borderline tumors are alive with no evidence of disease after a mean follow-up of 60 months.
Conclusions
In the present series, with accurate preoperative selection, the rate of adnexal cysts with unexpected intracystic vegetations was 5%, of which 14% were borderline tumors. The laparoscopic management of these adnexal masses did not adversely affect the prognosis.
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