Clinicopathological spectrum of gynecological pelvic masses: a cross-sectional study

Abstract

Background: Pelvic mass lesions are a commonly encountered entity in gynecological practice. These masses may be uterine or adnexal, benign or malignant. Clinicians have to be aware of their differential diagnosis to triage the patients and ensure optimum therapeutic approach. The objectives of this study were to study the diverse clinical spectrum of gynecological pelvic masses and to correlate the preoperative diagnosis based on clinical examination and ultrasonography with intraoperative surgical findings and histopathological examination.Methods: This was a cross sectional observational study on 114 patients with a diagnosis of pelvic mass who underwent laparotomy. All the patients were evaluated by a complete history, general abdominal and pelvic examination, followed by ultrasonography. These preoperative findings were then correlated with surgical findings and histopathological diagnosis.Results: 48% 0f the patients were in the age group of 41-50 years. The most common presenting complaint was lower abdominal/ pelvic pain seen in 78% of the patients. Uterine masses mostly presented as abdominal pain, abdominopelvic mass, menstrual complaints whereas ovarian masses presented with vague G. I symptoms or were asymptomatic. 37% of all masses were leiomyomas. There were 16 uterine malignancies and 14 ovarian cancer cases. Preoperative USG correlated well with histopathological diagnosis.Conclusions: A methodical approach consisting of a proper history, clinical examination, imaging studies and correct interpretation of diagnostic procedures is necessary for the triage and optimum management of gynecologic pelvic masses.