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Chapter 72 - Adnexal Mass in Pregnancy

from Section 12 - Malignant Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

By
Ahmed Nazer ,
Amira El-Messidi  and
Lucy Gilbert
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

You are seeing a patient referred by her primary care provider for consultation at your tertiary center’s high-risk obstetrics unit. She is a 37-year-old primigravida currently at 13+2 weeks’ gestation with an incidental 7-cm complex right adnexal mass detected last week on routine first-trimester sonography performed at an external center. Although the ultrasound report is not yet available to you, the consultation note confirms a singleton intrauterine pregnancy with normal fetal morphology and low risk of aneuploidy using sonographic markers. Routine serum prenatal investigations are only significant for iron-deficiency anemia.

Keywords

Ovarian mass, adnexal mass, pregnancyClinical presentationPhysical examinationDifferential diagnosisInvestigation, sonography, biomarkersPrenatal counselingLaparoscopy, surgeryPerinatal risks, complications, maternal-fetal morbidity, adverse outcomeAntepartum, intrapartum, postpartum managementChemotherapy, carboplatin, paclitaxelObstetric delivery implicationsBreastfeeding
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 909 - 921
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

Amant, F, Berveiller, P, Boere, IA, et al. Gynecologic cancers in pregnancy: guidelines based on a third international consensus meeting. Ann Oncol. 2019;30(10):1601–1612.CrossRefGoogle ScholarPubMed
Ball, E, Waters, N, Cooper, N, et al. Evidence-based guideline on laparoscopy in pregnancy: commissioned by the British Society for Gynaecological Endoscopy (BSGE) Endorsed by the Royal College of Obstetricians and Gynaecologists (RCOG). Facts Views Vis Obgyn. 2019;11(1):5–25. [Correction in Facts Views Vis Obgyn. 2020 Jan 24;11(3):261]Google ScholarPubMed
Blake, EA, Kodama, M, Yunokawa, M, et al. Feto-maternal outcomes of pregnancy complicated by epithelial ovarian cancer: a systematic review of literature. Eur J Obstet Gynecol Reprod Biol. 2015; 186:97–105.Google Scholar
Botha, M, Rajaram, S, Karunaratne, K. FIGO CANCER REPORT 2018. Cancer in pregnancy. Int J Gynecol Obstet 2018;143(Suppl. 2):137–142.CrossRefGoogle ScholarPubMed
Canavan, TP. Sonographic tips for evaluation of adnexal masses in pregnancy. Clin Obstet Gynecol. 2017;60(3):575–585.CrossRefGoogle ScholarPubMed
de Haan, J, Verheecke, M, Van Calsteren, K, et al. Oncological management and obstetric and neonatal outcomes for women diagnosed with cancer during pregnancy: a 20-year international cohort study of 1170 patients. Lancet Oncol. 2018;19(3):337–346.Google Scholar
Franciszek Dłuski, D, Mierzyński, R, Poniedziałek-Czajkowska, E, et al. Ovarian cancer and pregnancy – a current problem in perinatal medicine: a comprehensive review. Cancers (Basel). 2020;12(12):3795.Google Scholar
Fruscio, R, de Haan, J, Van Calsteren, K, et al. Ovarian cancer in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2017; 41:108–117.Google Scholar
Nazer, A, Czuzoj-Shulman, N, Oddy, L, et al. Incidence of maternal and neonatal outcomes in pregnancies complicated by ovarian masses. Arch Gynecol Obstet. 2015;292(5):1069–1074.Google Scholar
Pearl, JP, Price, RR, Tonkin, AE, et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc. 2017;31(10):3767–3782.Google Scholar

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