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What does an ovarian mass in pregnancy indicate?

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Posted on Mon, 14 Jul 2014
Question: Hi. I just recently had an MRI done on a large mass that was discovered at my last obgyn visit. My ob said the results are inconclusive. I'm 40 yrs old and 14wks pregnant. No history of cancer in close relatives. Here is the MRI report. There is a large multicystic right adnexal lesion with innumerable septations. There are areas of low intermediate and high t2 signals likely reflecting fluid content with very months of associated blood products. Solid components are not identified. The lesion is partially visualized measuring19.9 cm x 18.1 cm transverse. There is a single intrauterine pregnancy. There is no definite subchorionic hemorrhage. There is small pelvic free fluid. There appears to be an additional adjacent right adnexal cystic structure measuring 1.6 cm. Impression: large right adnexal cystic mass measuring 19.9 cm x 18.1 cm with innumerable internal septations and internal vesels. The appearance is suspicious for cystic neoplasm, possibly cystadenoma or cystadenocarcinoma. a dermoid is a differential consideration. I am very worried and would really appreciate a second opinion since my ob was unable to give me a definite answer. Your help in this matter were be greatly appreciated.XXXX
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Answered by Dr. Vivek Chail (2 hours later)
Brief Answer:
Further tests to know nature of tumor

Detailed Answer:
Hi XXXX
Thanks for writing in to us.

I have read through your query in detail.
The possibility of detecting an ovarian mass or lesion during routine imaging for pregnancy is around 2 to 10 % in various populations. As mentioned inyour MRI report, there is a 19.9 x 18.1 cms cystic mass (fluid filled) in your lower abdomen/ pelvis which is showing septations. This looks like a tumor originating from the oravy or its attachments. In most patients these tumors are harmless and allowed to stay within until the time of delivery when it can be treated. However any malignant tumor needs urgent attention. Because of the size of the mass you cannot rule out malignancy as any tumor more than 10 cms is suspected for malignancy. Its important to know when you first felt this swelling in the past and how large was it at that time. This may give an idea about the progressive growth of the tumor and what are the chances for a malignancy. There are also blood tests like CA-125 which can be done to know the probability of the tumor being malignant.

If the tumor is benign it can be left until delivery for treatment and you may get ultrasound scan of the tumor done regularly when getting the fetus scanned.

If any malignancy is confirmed by tests and surgical treatment advised then the best time to do such a surgery is from 14 to 22 weeks.

Please discuss this in detail with your gynecologist and you may also like to take clinical opinion from more that one doctors of your choice.

Hope your query is answered.
Do write back if you have any further doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6793 Questions

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What does an ovarian mass in pregnancy indicate?

Brief Answer: Further tests to know nature of tumor Detailed Answer: Hi XXXX Thanks for writing in to us. I have read through your query in detail. The possibility of detecting an ovarian mass or lesion during routine imaging for pregnancy is around 2 to 10 % in various populations. As mentioned inyour MRI report, there is a 19.9 x 18.1 cms cystic mass (fluid filled) in your lower abdomen/ pelvis which is showing septations. This looks like a tumor originating from the oravy or its attachments. In most patients these tumors are harmless and allowed to stay within until the time of delivery when it can be treated. However any malignant tumor needs urgent attention. Because of the size of the mass you cannot rule out malignancy as any tumor more than 10 cms is suspected for malignancy. Its important to know when you first felt this swelling in the past and how large was it at that time. This may give an idea about the progressive growth of the tumor and what are the chances for a malignancy. There are also blood tests like CA-125 which can be done to know the probability of the tumor being malignant. If the tumor is benign it can be left until delivery for treatment and you may get ultrasound scan of the tumor done regularly when getting the fetus scanned. If any malignancy is confirmed by tests and surgical treatment advised then the best time to do such a surgery is from 14 to 22 weeks. Please discuss this in detail with your gynecologist and you may also like to take clinical opinion from more that one doctors of your choice. Hope your query is answered. Do write back if you have any further doubts. Regards, Dr.Vivek