Presence or absence of normal ovarian tissue adjacent to adnexal mass: A discriminative sonographic sign to suspect malignancy

Kushtagi, Pralhad and Kulkarni, Kiran Kalghatgi (2010) Presence or absence of normal ovarian tissue adjacent to adnexal mass: A discriminative sonographic sign to suspect malignancy. Indian Journal of Cancer , 47 (4).

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It has been claimed that the presence of normal ovarian tissue adjacent to an adnexal mass, ovarian crescent sign (OCS) excludes the likelihood of a malignant lesion. And it is considered to be a reliable and simple sonographic marker in preoperative evaluation. We studied 60 women attending gynecology service with adnexal mass requiring surgery. Ultrasound scanning was done by a single gynecologist who was not aware of the clinical details. Its presence or absence was correlated with the histopathology examination report of the tumor obtained at surgery. Ovarian crescent was identified in 65% of the cases (39 of 60 cases; 38 benign and 1 malignant disease) scanned. There were 11 malignant cases on histopathologic examination. Of the 39 cases with positive OCS, 38 masses (97.4%) were later found to be benign. In the absence of OCS, 10 of 21 cases (47.6%) were malignant, thus giving the clinician a tool with high specificity (90.9%), positive predictive value (97.4%), and a respectable sensitivity (77.6%) in prejudging the nature of adnexal masses. Data from all the 3 reported studies by the same group[1,2,3] suggests that OCS is more often present in benign lesions (270 of 306 cases, 88%) and absent in malignant lesions (72 of 75 cases, 96%). The identification of OCS may get masked in the case of masses with multiple cysts or heavily echogenic shadows as in fibromas, dermoid cysts, endometriomas, and abscesses. In such cases reliance on the crescent sign should be viewed in the backdrop of other clinical characteristics. In addition, probability of failure to identify normal ovarian tissue in large ovarian lesions should be borne in mind. We wish to reiterate that one should look for the crescent during pelvic ultrasound evaluation of adnexal masses.

Item Type: Article
Uncontrolled Keywords: Adnexal mass, ovarian crescent sign, sonography, preoperative evaluation
Subjects: Medicine > KMC Mangalore > Obstetrics & Gynaecology
Depositing User: KMCMLR User
Date Deposited: 12 Sep 2011 06:25
Last Modified: 18 Oct 2011 06:34

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