Conservative management of adnexal masses
Menée à partir de données portant sur 1 919 patientes bénéficiant d'une surveillance médicale pour une tumeur ovarienne présumée bénigne à l'échographie (durée médiane de suivi : 27 mois), cette étude internationale estime le risque de complications aiguës et de transformation maligne dans les deux ans qui suivent l'examen échographique
Adnexal masses are common and often identified incidentally. This diagnosis often leads to additional investigations and interventions that could cause morbidity with unknown or questionable clinical benefit. Generally, ovarian tumours do not undergo preoperative biopsy to avoid disrupting the ovarian capsule, which can cause dissemination of malignant cells. Hence, without a definitive tissue diagnosis, clinicians are often reliant on other tools to determine the clinical implications of a neoplasm. Therefore, reliable clinical tools are essential to aid in decision making when a woman presents with a new adnexal lesion. Many practitioners often depend on additional investigations such as serum tumour markers, MRI, and the risk of malignancy index (RMI) algorithm; however, these tests are non-specific and carry low predictive values.
The Lancet Oncology , commentaire, 2018