Adnexal Mass FAQs

Q: What is an Adnexal Mass?

A: An adnexal mass is a mass that has grown in the uterine adnexa. The adnexa include the fallopian tubes and ovaries. These masses can have a variety of causes including:

  • simple ovarian cysts
  • benign ovarian tumors
  • malignant ovarian tumors
  • irregularities in the fallopian tubes

Q: What are the symptoms of Adnexal Masses?

A: Many women don't have symptoms. The gynecologist often finds these masses during a routine exam. Depending on the cause of the mass, you may feel pelvic pain. Or you may have irregular menstrual periods. Some larger masses may cause pressure on the bladder or rectum. This can lead to an increase in the frequency of urination. It can also cause constipation. Abdominal swelling that makes clothes fit tighter can occur. This swelling is often accompanied by weight loss.

Sometimes a mass may twist, cutting off the blood supply to the ovary. This is called ovarian torsion. It causes sudden severe pain. Fortunately, it doesn’t happen often. If you have symptoms—especially a group of them, or a prolonged period and they are severe—ask a doctor or nurse practitioner for an evaluation. You want to make sure there is not a serious problem like ovarian cancer that’s causing them. Most women with small adnexal masses will have no symptoms at all.

Q: How are adnexal masses diagnosed?

A: Symptoms of adnexal masses can be caused by other, less serious problems. So you should discuss your symptoms with your doctor. To determine the cause of your symptoms, your doctor will examine you. Your doctor will also ask you about your personal and family medical history. In addition, the doctor may also perform one or more of these tests:

  • Pelvic exam. The doctor usually finds adnexal masses during a pelvic exam. During the exam, the doctor feels the vagina, uterus, ovaries, bladder, and rectum. This is to check for lumps or anything unusual. The doctor will use an instrument called a speculum. It makes the vagina wider. That way, the doctor can see the top part of the vagina and the cervix.
  • Ultrasonography. If the doctor feels an adnexal mass, he or she will often ask for a pelvic sonogram. This is also called an ultrasound. The doctor may also ask for a sonogram if you are having pelvic symptoms. For this test, sound waves are aimed at the ovaries. The waves form a picture called a sonogram. A special computer transforms the echoes into pictures. Then they can be viewed on a screen. The uterus, tubes, and ovaries can be seen very well on a sonogram. Often even clearer pictures are seen when the sonogram is done through the vagina as well as the abdomen. The echoes sound different for healthy tissues, fluid-filled cysts, and solid tumors. If an adnexal mass is there, the radiologist will be able to describe its size, location, and appearance. If you have adnexal masses, the doctor will want to know whether the masses are cystic (fluid filled), solid, or both (complex). Masses that are mostly composed of fluid—cysts—are less suspicious for cancer than are masses that contain solid areas.

Q: Should everyone get a second opinion?

A: Second opinions are often a good idea. Reasons for them include:

  • your comfort with the treatment decision
  • whether the cancer is rare
  • how many options there are for treating the cancer
  • your ability to see a cancer expert

Q: How can someone get a second opinion?

A: There are many ways to get a second opinion:

  • Your primary doctor may be able to give you the name of a specialist. This may be a surgeon, medical oncologist, radiation oncologist, or plastic surgeon. Sometimes these doctors work together at cancer centers or programs.
  • The Gynecologic Cancer Foundation (GCF) has a hotline. The number is 1-800-444-4441. The hotline can assist you in finding a gynecologic oncologist for a second opinion.
  • The WCN web site has a Find-A-Doctor tool. You can use it to search for a gynecologic oncologist. The search results will be based on your zip code.
  • The Cancer Information Service can tell you about treatment facilities. These include cancer centers and other programs supported by the National Cancer Institute. The number is 1-800-4-CANCER or 1-800-422-6237.
  • You can get names of doctors from your local medical society. You can also ask for names at a nearby hospital. Medical schools or local cancer advocacy groups are also good sources for names. Another way to get names of doctors is to ask people who have had the type of cancer you do.
  • The Directory of Medical Specialists is in most public libraries. It lists doctors by state and specialty. It also tells about their background.

Q: What are clinical trials?

A: Clinical trials are studies of new kinds of cancer treatments. Doctors conduct clinical trials to learn about how well new treatments work and what their side effects are. If they look promising, they are then compared to the current treatment. The comparison shows if it works better or has fewer side effects. People who participate in these studies may benefit from new treatments before the FDA approves them. The FDA is the government agency in charge of new treatments for diseases. People who take part also help further our understanding of cancer and help future cancer patients.

Reviewed By:
Wesley J. Fowler, Jr., MD, Vice Chair and full Professor, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill
Karl Podratz, MD, Professor, Department of Obstetrics and Gynecology, Mayo Medical School. Director, Gynecologic Oncology Fellowship Training Program, Mayo Clinic
Jonathan S. Berek, MD, Professor, UCLA School of Medicine. Director, Gynecologic Oncology Service, Department of Obstetrics/Gynecology and Member and Principal Investigator, Gynecologic Oncology Group, UCLA School of Medicine

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