Adnexal Masses in Postmenopausal Women

Adnexal masses in postmenopausal women were reviewed according to size, pathology, age of the patient, and accuracy of ultrasound versus pelvic examination. Only one of 32 masses less than 5 cm in diameter was malignant. Of 55 masses 5–10 cm in size, six were malignant, including one lymphoma and two borderline tumors. Forty of 63 tumors larger than 10 cm were malignant. The proportion of malignancies increased with age. Pelvic examination missed 10% of tumors less than 10 cm in diameter. Of those palpated, the examination predicted the size of the mass to within 2 cm in 68% of cases. Ultrasonic prediction of size was accurate in 87% of cases scanned. Our findings cast doubt on the concept that all postmenopausal women with minimally enlarged ovaries should undergo laparotomy.