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Abdominal masses in gynecology

Abdominal or pelvic mass can present at any age of life. In a random sample of 335 asymptomatic women aged 25–40 years, the point prevalence of an adnexal lesion on ultrasound examination was 7.8%(prevalence of ovarian cysts 6.6%)1. Preva- in a woman’s lower abdo-lence of pelvic masses in postmenopausal women can vary widely from 2.5% to 10% in postmeno-pausal women. | 11 Abdominal Masses in Gynecology Pubudu Pathiraja INTRODUCTION Abdominal or pelvic mass can present at any age of life. In a random sample of 335 asymptomatic women aged 25-40 years the point prevalence of an adnexal lesion on ultrasound examination was 7.8 prevalence of ovarian cysts 6.6 f Prevalence of pelvic masses in postmenopausal women can vary widely from 2.5 2 to 10 3 in postmenopausal women. A woman presenting with an abdominal or pelvic mass might complain of various symptoms but a significant majority will have no guiding obvious symptoms at presentation although the final diagnosis may be life-threatening. The abdomen can be distended by either a solid or cystic mass or by free fluid in the abdomen. To distinguish between masses and free fluid you must examine the patient and sometimes you will need to perform an ultrasound as described in Chapter 1. ABDOMINAL MASSES VERSUS A DISTENDED ABDOMEN CAUSED BY FLUID Free fluid in the abdomen can either be ascites blood chylus or pus. Table 1 shows the most important gynecological causes of free fluid in the abdomen. This chapter focuses on abdominal masses. CLASSIFICATION OF ABDOMINAL MASSES A patient with an abdominal mass may present with symptoms but the mass might only be detected during physical examination or even only through ultrasound. This chapter deals with palpable and sonographically detectable masses as the difference between the two may only be in size but not necessarily in treatment. Some pelvic masses typically present only sonographically for example Endometrioma Hydro- pyosalpinx Sero- hematometra If you diagnose a mass in a woman s lower abdomen you must decide on Which organ the tumor arises from organ specificity . Lower abdominal masses can be divided according to their anatomical origin in genital and extragenital masses Table 2 . What kind of tumor you are dealing with entity i.e. malignant or benign . Table 1 Common gynecological causes of free fluid in the abdomen Free fluid Cause