Adnexal tumors are growths that form on the organs and connective tissues around the uterus in women. Adnexal tumors are most often noncancerous (benign), but they can be cancerous (malignant).Adnexal tumors occur in the Ovaries, Fallopian tubes, Connective tissue around the ovaries or fallopian tubes. Diagnosis of adnexal tumors involves a careful physical exam, imaging tests and, sometimes, surgery. Treatment for adnexal tumors depends on the specific location and types of cells involved.
The pathophysiology is not well understood for most adnexal masses; however, some theories have been proposed. Functional cysts may be the result of variation in normal follicle formation. Mature cystic teratoma may be the result of abnormal germ cell proliferation. Endometriomas are thought to result from retrograde menstruation or coelomic metaplasia. The exact cause of epithelial neoplasms is unknown, but recent studies have suggested a complex series of molecular genetic changes is involved.
In girls younger than 9 years, 80% of ovarian masses are malignant and are generally germ cell tumors. During adolescence, 50% of adnexal neoplasms are mature cystic teratomas (often known as dermoid cysts). Women with gonads that contain a Y chromosome have a 25% chance of developing a malignant neoplasm (most commonly a dysgerminoma). Endometriosis is uncommon in adolescent women but may be present in as many as 50% of those who present with a painful mass. In sexually active adolescents, one must always consider a tubo-ovarian abscess as the cause of an adnexal mass.