If your doctor examines you and says, "You have a mass in your lower abdomen," it's normal to feel very scared and anxious. When we hear the word "mass," our minds immediately think of something scary. But don't worry. Most masses that are diagnosed this way, called "adnexal masses," are not cancerous. So let's talk about this in a simple and straightforward way.
What exactly is this Adnexal Mass?
Simply put, an ``adnexal mass'' is a growth or tumor that develops near your uterus, that is, in the organs that are attached to it. Doctors use this name to describe various types of tumors that develop in your pelvic region.
The word "adnexa" means "attached parts." In this case, it refers to the ovaries, fallopian tubes, and the connective tissue that supports these organs . So, any tumor that develops in these parts is called an "adnexal mass."
Remember, some of these lumps can be filled with fluid (we call these cysts), while others can be solid. The important thing is that the vast majority of these ``Adnexal Masses`` are not cancerous (benign). And some of them go away on their own within a few months without any treatment.
What are the symptoms of this condition?
Not everyone develops symptoms. Sometimes they are discovered incidentally during a scan done for another reason. But if symptoms do occur, the symptoms can vary depending on the location of the tumor and its cause.
Check out the table below to see what symptoms are commonly seen.
| Symptom | Description |
|---|---|
| Pelvic pain | It can be a constant dull ache or a sudden, severe pain. |
| Difficulty urinating | You may feel difficulty urinating or need to urinate frequently. |
| Irregular menstruation | The monthly menstrual cycle may be irregular and not as usual. |
| Bloating | Feeling bloated, as if the stomach is full of gas. |
| Constipation | Difficulty defecating as usual. |
| Pain during sex | Feeling pain during sex with your husband. |
What are the causes of adnexal mass formation?
These tumors can develop due to both gynecological and non-gynecological causes. However, most often they develop due to causes related to the reproductive system .
Gynecologic Causes
These are the most common reasons.
- Ovarian Cysts: Fluid-filled cysts that form on the surface of the ovaries. These are very common. Most of the time, they are painless and do not cause any symptoms.
- Noncancerous ovarian tumors: Cells in the ovaries grow abnormally, forming solid tumors. These are benign and do not usually spread to other areas.
- Ectopic Pregnancy: A fertilized egg implants itself somewhere else, such as a fallopian tube, instead of in the uterus. This is a very dangerous condition. It can cause internal bleeding and severe pain. If left untreated, it can even be life-threatening for the mother.
- Corpus Luteum Cyst: A harmless, painless cyst that forms during ovulation. These go away on their own after ovulation.
- PCOS (Polycystic Ovary Syndrome): This is a hormonal condition that can cause many small cysts to form on the ovaries.
- Endometriomas: These are related to a condition called endometriosis. This is where fluid-filled cysts filled with menstrual blood form in the ovaries.
- Hydrosalpinx: A condition in which a fallopian tube becomes filled with fluid and forms a sac-like structure. Although it is usually asymptomatic, it can sometimes cause lower abdominal pain or difficulty conceiving.
- Ovarian Cancer: If a tumor that forms in an ovary becomes malignant, it can grow and spread to other parts of the body. But remember, only a very small percentage of adnexal masses become cancerous.
Nongynecologic Causes
These usually arise from parts of the digestive or urinary system. They have no connection to the uterus, ovaries, or fallopian tubes.
- Tumors in the colon, bladder, and appendix.
- In rare cases, these types of tumors can also develop when other cancers, such as breast cancer or colon cancer, spread (metastasize) to the pelvic area.
Can an adnexal mass be dangerous?
Most adnexal masses are not dangerous. However, some masses can cause serious complications. Ectopic pregnancy, cancerous masses, ruptured adnexal masses, and twisting of the ovary or fallopian tube (adnexal torsion) are conditions that require emergency medical attention.
If you have an ``Adnexal Mass'' and are also experiencing symptoms such as severe lower abdominal pain, nausea or vomiting, and fever, it could be a sign of an emergency. In such cases, see a doctor immediately or go to the hospital's Emergency Department (ETU).
Just because you have a lump doesn't mean it's cancer. Most lumps are non-cancerous (benign). However, an adnexal mass that develops in women after menopause has a slightly higher risk of becoming cancerous (malignant).
How does the doctor diagnose and treat this?
Usually, a doctor suspects you have a lump during a pelvic exam. They will then order an ultrasound scan to look at it more closely. Sometimes, a biopsy or surgery may be needed to check for cancer cells in the lump.
In addition, tests such as a pregnancy test, blood tests, and, if necessary, a CT scan or MRI scan can be performed to rule out an ectopic pregnancy.
The treatment depends on many factors, including the cause of the tumor, its size, and your symptoms. There are three main treatment options.
| Treatment method | When will this be done? |
|---|---|
| Without treatment | If the tumor is small, not painful, and the doctor is confident that it is not cancerous, he or she may recommend no treatment. |
| Close monitoring | If the exact cause of the tumor is not clear, or if there is any concern about the size of the tumor or symptoms, the doctor will perform frequent scans to monitor its changes. |
| Surgery | If the tumor is suspected to be cancerous, is large in size (usually more than 6-10 centimeters), is causing you severe pain, or is an ectopic pregnancy, it will be removed surgically. |
Things to ask your doctor
Once you find out that you have an ``(Adnexal Mass)``, ask your doctor any questions you have. For example:
- Will I need surgery?
- How often do you check this tumor?
- Is there a small chance that this could be cancer?
- What symptoms should I report immediately if they occur?
While it's normal to feel scared when you hear the word "tumor," try not to panic until you've talked to your doctor and gotten the right information. Remember, most of these things aren't dangerous, and some get better on their own.
Take-Home Message
- An ``Adnexal Mass`` is a tumor that develops in the organs surrounding the uterus. The vast majority of these are not cancerous.
- Don't panic just because you hear the word "tumor." Stay calm until you get a proper diagnosis.
- Some people may not experience any symptoms. If symptoms do occur, they may experience lower abdominal pain and difficulty urinating.
- Treatment depends on the cause of the tumor, its size, and your symptoms. Often, observation is sufficient.
- Follow your doctor's instructions and go for checkups on scheduled dates.
- If you experience symptoms such as severe abdominal pain, fever, nausea, or vomiting, seek medical advice immediately as it may be an emergency.
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