Evaluation of Adnexal Masses in Adolescents

To estimate the incidence and distribution of adnexal masses in the adolescent population is difficult because of the rarity of the condition.In studies of adnexal masses detected by sonography, non-neoplastic lesions accounted for the majority of adnexal masses in adolescents, 75% to 98% (Table l).&, 91, 99, lo* Malignancies were exceedingly rare *in these series.These studies most closely reflect the distribution of the different pathologic entities because they include both surgically managed and expectantly managed cases.The majority of studies in the literature are series of surgical cases with pathologic evaluation.Non-neoplastic masses are less likely to be detected, and the malignancy rate is probably overestimated with this method.The reported rate of malignancy is also affected by the patient population studied.Diamond et a P studied ovarian masses at five hospitals in Nashville.The university hospital reported a 24% malignancy rate, whereas the community hospitals reported 6%.Adolescents make up a very small fraction of women with ovarian neoplasms (approximately 6%)&, lo3 and an even smaller fraction of women with ovarian cancer?"66, Io3* lo4 Among all childhood malignancies, ovarian cancer constitutes only approximately 1%.37 It is, however, the most common genital tract malignancy in adolescents. DIFFERENTIAL DIAGNOSISAdnexal masses arise from the ovary and other pelvic structures (Table 2).When sonography is used to detect masses in these patients, ovarian cysts are