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Incidental Adnexal Masses Not Uncommon at Colonography

Additional assessment finds no ovarian cancer in group with masses identified at unenhanced CT

THURSDAY, Sept. 23 (HealthDay News) -- Among older women undergoing colonography, incidental indeterminate adnexal masses identified at unenhanced computed tomography (CT) are relatively common, though additional work-up isn't likely to find ovarian cancers; however, women with normal findings at CT aren't protected from developing ovarian cancer in the next few years, according to research published in the October issue of Radiology.

Perry J. Pickhardt, M.D., and Meghan E. Hanson, M.D., of the University of Wisconsin School of Medicine and Public Health in Madison, analyzed data from 2,869 women ages 50 and older who underwent colonography screening.

The researchers found that 118 women (4.1 percent) had an indeterminate adnexal mass at prospective CT interpretation. Eighty women underwent further imaging evaluation and/or surgery. Surgically excised lesions were most often found to be cystadenoma or cystadenofibroma. No ovarian cancers were found in this group, though four cases developed among the remaining women in a 15- to 44-month period.

"In summary, incidental indeterminate adnexal lesions are commonly encountered at CT in postmenopausal women, yet diagnostic work-up of these lesions may only rarely uncover ovarian cancer at an early stage. This supports the notion that the time window for presymptomatic cancer detection may be too narrow for screening of the general population. On the basis of our findings, more refined risk factor assessment with better identification of women and higher risk and perhaps less aggressive management of low-risk cases would appear to be warranted," the authors conclude.

Pickhardt disclosed financial relationships with Medicsight, Viatronix, Philips, and VirtuoCTC.

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