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.
Ovarian cancer represents one fourth of the malignancies of the female genital tract, but it is the most common cause of death among women who develop cancers of gynecologic origin. Ovarian carcinomas account for 4% of the total cancers in women in the United States, ranked behind malignant neoplasms of the lung, breast, colon and uterus. In 2003, over 24,400 new cases and 14,300 deaths are expected. Despite these discouraging statistics, improvement in 5-year survival has occurred steadily over the last three decades with more aggressive surgical management and the development of more effective chemotherapy. Five-year survival in the United States has improved significantly (p < .05) from 37% in 1974-76 to 52% in 1992-1998. Ovarian cancer is a disease of postmenopausal women, with only 10% to 15% discovered in premenopausal patients. The median age for diagnosis of epithelial ovarian cancer, the most common histologic type, is between 60 and 65 years. Less than 1% of epithelial ovarian cancers are found in women less than 30 years of age, and most ovarian malignancies in these younger patients are germ cell tumors.