Table of ContentsView AllTable of ContentsCausesSymptoms of an Adnexal MassHow Is an Adnexal Mass Diagnosed?
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms of an Adnexal Mass
How Is an Adnexal Mass Diagnosed?
Anadnexalmass is an abnormal growth that develops near the uterus, usually in the ovaries,fallopiantubes, or surrounding connective tissues. The mass can be solid or fluid-filled, benign (noncancerous) or malignant (cancerous).
This article discusses the different types of adnexal masses and their causes. It also looks at symptoms, diagnosis, and treatment of adnexal masses.
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Types and Causes of Adnexal Masses
There are hundreds of reasons why an adnexal mass may develop. In premenopausal, non-pregnant women, most adnexal masses areovarian cysts. There are several different types of ovarian cysts. They include:
Most ovarian cysts are non-cancerous and resolve on their own. In postmenopausal women, a healthcare provider should monitor cysts that are larger than 3 cm.
Other causes of adnexal masses include:
Masses larger than 6 cm are more likely to be cancerous than smaller masses.
Adnexal masses are relatively common. For this reason, healthcare providers have to consider many factors to find the cause and classification of the growth.
Red FlagsCancer is only one of many possible causes. Red flags are typically raised if:The mass is solid instead of cysticThe mass is irregular in shape or densityThe mass develops before menstruation beginsThe mass develops after menopauseThe mass is painfulThe cyst is extremely large
Red Flags
Cancer is only one of many possible causes. Red flags are typically raised if:The mass is solid instead of cysticThe mass is irregular in shape or densityThe mass develops before menstruation beginsThe mass develops after menopauseThe mass is painfulThe cyst is extremely large
Cancer is only one of many possible causes. Red flags are typically raised if:
Adnexal masses don’t always cause symptoms. When they do, symptoms may include:
The majority of adnexal masses resolve on their own within a few weeks. Others grow slowly, averaging less than 2 mm per year. In rare cases, an adnexal cyst may grow rapidly or reach a large size and need to be surgically removed.
You’ll need additional tests if your healthcare provider finds an adnexal mass during a physical exam. Imaging tests that can help with the diagnosis include:
A pregnancy test can help diagnose atubalpregnancy. If ovarian cancer is suspected, a CA 125 test may be ordered. This test measures levels of a protein called cancer antigen 125 in the blood.
If the mass is cystic, your healthcare provider may perform an aspiration to extract fluid with a needle and syringe. However, many healthcare providers will avoid this, especially if cancer is suspected. This is because the extracted fluid may contain malignant cells that can seed other tumors.
How Is an Adnexal Mass Treated?
Your initial test results will help determine your treatment. The majority of adnexal masses resolve on their own within a few weeks. Others grow slowly, averaging less than 2 mm per year. In rare cases, an adnexal cyst may grow rapidly or reach a large size and need to be surgically removed.
If the mass is a tubal pregnancy, emergency treatment may be required. This will prevent a potentially life-threateningrupture, especially if you have symptoms.
In most cases, an adnexal mass will not be a cause for alarm and may never create any health problems.
That said, healthcare providers will pay particular attention to any masses or lesions in or around the ovaries or fallopian tubes. Studies have shown that growths in the fallopian tubes often serve as precursors to a type of cancer called high-grade serous ovarian carcinoma (HGSOC). This cancer may not show up until years after the growth appears. HGSOC accounts for around 75% of all ovarian cancers.
Summary
Adnexal masses are usually not cancerous. They may be associated with ovarian cysts, endometriosis, and polycystic ovary syndrome. Some can be immediately life-threatening, as in the case of an ectopic pregnancy.
Adnexal masses are usually diagnosed with an imaging test like a transvaginal ultrasound or an MRI scan. Depending on the cause, they may be treated with a watch-and-wait approach or with surgery.
A Word From Verywell
Even if the adnexal mass turns out to be benign, a gynecologic oncologist will be better able to determine when changes in the growth require more aggressive interventions.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Biggs WS, Marks ST.Diagnosis and management of adnexal masses.Am Fam Physician. 2016;93(8):676-81.Medvediev MV, Malvasi A, Gustapane S, Tinelli A.Hemorrhagic corpus luteum: clinical management update.Turk J Obstet Gynecol. 2020;17(4):300-309. doi:10.4274/tjod.galenos.2020.40359Jha P, Shekhar M, Goldstein R, Morgan T, Poder L.Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm.Abdom Radiol (NY). 2020;45(10):3213-3217. doi:10.1007/s00261-019-02176-zAmerican College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology.Practice Bulletin No. 174: evaluation and management of adnexal masses.Obstet Gynecol. 2016;128(5):e210-e226. doi:10.1097/AOG.0000000000001768Deguchy Q, Fananapazir G, Corwin M, Lamba R, Gerscovich E, McGahan J.Benign rapidly growing ovarian dermoid cysts: a case series.J Diagn Med Sonography.2017;33(1):71-74. doi:10.1177/8756479316664313Cole CJ, Russell KS, Han JJ.The role of imaging in the evaluation of adnexal masses.Curr Womens Health Rev. 2019;15(1):12-22. doi:10.2174/1573404814666171205102008Muto MG.Approach to the patient with an adnexal mass. In: Sharp HT, Goff B, Levine D, eds.UpToDate. Waltham, Mass: UpToDate; 2022.Labidi-galy SI, Papp E, Hallberg D, et al.High grade serous ovarian carcinomas originate in the fallopian tube.Nat Commun. 2017;8(1):1093. doi:10.1038/s41467-017-00962-1Stewart SL, Cooney D, Hirsch S, et al.The effect of gynecologic oncologist availability on ovarian cancer mortality.World J Obstet Gynecol. 2014;3(2):71-77. doi:10.5317/wjog.v3.i2.71Additional ReadingDodge J.Management of a suspicious adnexal mass: a clinical practice guideline.Curr Oncology. 2012;19(4):e244-57. doi:10.3747/co.19.980Suh-Burgmann E, Kinney W.Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses.Amer J Obstetric Gynecol. 2015;213(6):816.e1-4. doi:10.1016/j.ajog.2015.09.005
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Biggs WS, Marks ST.Diagnosis and management of adnexal masses.Am Fam Physician. 2016;93(8):676-81.Medvediev MV, Malvasi A, Gustapane S, Tinelli A.Hemorrhagic corpus luteum: clinical management update.Turk J Obstet Gynecol. 2020;17(4):300-309. doi:10.4274/tjod.galenos.2020.40359Jha P, Shekhar M, Goldstein R, Morgan T, Poder L.Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm.Abdom Radiol (NY). 2020;45(10):3213-3217. doi:10.1007/s00261-019-02176-zAmerican College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology.Practice Bulletin No. 174: evaluation and management of adnexal masses.Obstet Gynecol. 2016;128(5):e210-e226. doi:10.1097/AOG.0000000000001768Deguchy Q, Fananapazir G, Corwin M, Lamba R, Gerscovich E, McGahan J.Benign rapidly growing ovarian dermoid cysts: a case series.J Diagn Med Sonography.2017;33(1):71-74. doi:10.1177/8756479316664313Cole CJ, Russell KS, Han JJ.The role of imaging in the evaluation of adnexal masses.Curr Womens Health Rev. 2019;15(1):12-22. doi:10.2174/1573404814666171205102008Muto MG.Approach to the patient with an adnexal mass. In: Sharp HT, Goff B, Levine D, eds.UpToDate. Waltham, Mass: UpToDate; 2022.Labidi-galy SI, Papp E, Hallberg D, et al.High grade serous ovarian carcinomas originate in the fallopian tube.Nat Commun. 2017;8(1):1093. doi:10.1038/s41467-017-00962-1Stewart SL, Cooney D, Hirsch S, et al.The effect of gynecologic oncologist availability on ovarian cancer mortality.World J Obstet Gynecol. 2014;3(2):71-77. doi:10.5317/wjog.v3.i2.71Additional ReadingDodge J.Management of a suspicious adnexal mass: a clinical practice guideline.Curr Oncology. 2012;19(4):e244-57. doi:10.3747/co.19.980Suh-Burgmann E, Kinney W.Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses.Amer J Obstetric Gynecol. 2015;213(6):816.e1-4. doi:10.1016/j.ajog.2015.09.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Biggs WS, Marks ST.Diagnosis and management of adnexal masses.Am Fam Physician. 2016;93(8):676-81.Medvediev MV, Malvasi A, Gustapane S, Tinelli A.Hemorrhagic corpus luteum: clinical management update.Turk J Obstet Gynecol. 2020;17(4):300-309. doi:10.4274/tjod.galenos.2020.40359Jha P, Shekhar M, Goldstein R, Morgan T, Poder L.Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm.Abdom Radiol (NY). 2020;45(10):3213-3217. doi:10.1007/s00261-019-02176-zAmerican College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology.Practice Bulletin No. 174: evaluation and management of adnexal masses.Obstet Gynecol. 2016;128(5):e210-e226. doi:10.1097/AOG.0000000000001768Deguchy Q, Fananapazir G, Corwin M, Lamba R, Gerscovich E, McGahan J.Benign rapidly growing ovarian dermoid cysts: a case series.J Diagn Med Sonography.2017;33(1):71-74. doi:10.1177/8756479316664313Cole CJ, Russell KS, Han JJ.The role of imaging in the evaluation of adnexal masses.Curr Womens Health Rev. 2019;15(1):12-22. doi:10.2174/1573404814666171205102008Muto MG.Approach to the patient with an adnexal mass. In: Sharp HT, Goff B, Levine D, eds.UpToDate. Waltham, Mass: UpToDate; 2022.Labidi-galy SI, Papp E, Hallberg D, et al.High grade serous ovarian carcinomas originate in the fallopian tube.Nat Commun. 2017;8(1):1093. doi:10.1038/s41467-017-00962-1Stewart SL, Cooney D, Hirsch S, et al.The effect of gynecologic oncologist availability on ovarian cancer mortality.World J Obstet Gynecol. 2014;3(2):71-77. doi:10.5317/wjog.v3.i2.71
Biggs WS, Marks ST.Diagnosis and management of adnexal masses.Am Fam Physician. 2016;93(8):676-81.
Medvediev MV, Malvasi A, Gustapane S, Tinelli A.Hemorrhagic corpus luteum: clinical management update.Turk J Obstet Gynecol. 2020;17(4):300-309. doi:10.4274/tjod.galenos.2020.40359
Jha P, Shekhar M, Goldstein R, Morgan T, Poder L.Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm.Abdom Radiol (NY). 2020;45(10):3213-3217. doi:10.1007/s00261-019-02176-z
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology.Practice Bulletin No. 174: evaluation and management of adnexal masses.Obstet Gynecol. 2016;128(5):e210-e226. doi:10.1097/AOG.0000000000001768
Deguchy Q, Fananapazir G, Corwin M, Lamba R, Gerscovich E, McGahan J.Benign rapidly growing ovarian dermoid cysts: a case series.J Diagn Med Sonography.2017;33(1):71-74. doi:10.1177/8756479316664313
Cole CJ, Russell KS, Han JJ.The role of imaging in the evaluation of adnexal masses.Curr Womens Health Rev. 2019;15(1):12-22. doi:10.2174/1573404814666171205102008
Muto MG.Approach to the patient with an adnexal mass. In: Sharp HT, Goff B, Levine D, eds.UpToDate. Waltham, Mass: UpToDate; 2022.
Labidi-galy SI, Papp E, Hallberg D, et al.High grade serous ovarian carcinomas originate in the fallopian tube.Nat Commun. 2017;8(1):1093. doi:10.1038/s41467-017-00962-1
Stewart SL, Cooney D, Hirsch S, et al.The effect of gynecologic oncologist availability on ovarian cancer mortality.World J Obstet Gynecol. 2014;3(2):71-77. doi:10.5317/wjog.v3.i2.71
Dodge J.Management of a suspicious adnexal mass: a clinical practice guideline.Curr Oncology. 2012;19(4):e244-57. doi:10.3747/co.19.980Suh-Burgmann E, Kinney W.Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses.Amer J Obstetric Gynecol. 2015;213(6):816.e1-4. doi:10.1016/j.ajog.2015.09.005
Dodge J.Management of a suspicious adnexal mass: a clinical practice guideline.Curr Oncology. 2012;19(4):e244-57. doi:10.3747/co.19.980
Suh-Burgmann E, Kinney W.Potential harms outweigh benefits of indefinite monitoring of stable adnexal masses.Amer J Obstetric Gynecol. 2015;213(6):816.e1-4. doi:10.1016/j.ajog.2015.09.005
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