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Abstract
Ovarian cancer is the fifth most common cause of cancer death in women in Europe with an overall incidence of 15.5
cases per year in 100,000 people. Survival depends on the tumor stage with a 5-year survival rate of over 85% in stage I disease. However, 75% of the patients present with an advanced stage at the time of diagnosis (Modugno, 2003).
Therefore, screening modalities, i.e. CA125 measurement and transvaginal ultrasound, are investigated for their capacity to detect early ovarian cancer in the general population (Van Nagell et al., 2000). These efforts are, however, hampered by the low incidence rates and the high fraction of false positive results (Bosse et al., 2006).
However, as an adnexal mass may represent benign or malignant conditions, and can behave in an atypical manner,its diagnosis is a challenge to gynecologists (Manjunath et al.,2001).
Because the standard strategy for establishing a final diagnosis is exploratory laparotomy, many women with
advanced ovarian carcinoma undergo suboptimal primary surgery at their local hospitals. The amount of residual tumor after primary surgery (Kehoe et al., 1994), the type of operation, and the experience of the surgeon (Gillis et al., 1991) are important prognostic factors in ovarian cancer.
Therefore, a method for better preoperative evaluation of women with pelvic masses is needed to optimally plan their management (Obeidat et al., 2004).
Ultrasonography is accepted as the primary imaging modality in the evaluation of an ovarian mass. The use of ultrasonography in the detection of a suspected ovarian mass and in its differentiation from a uterine mass has been well established.
Because ultrasonography depicts the mass, characterization of the mass is typically performed during the
same examination. Thus, de facto, ultrasonography becomes the main triage method prior to treatment (Kinkel et al., 2000).
A majority of ovarian masses are non-neoplastic cysts.
However, when a lesion is suspected of being a neoplasm, surgical intervention must be considered. Twenty-five percent
of ovarian neoplasms are malignant. For this reason, surgical removal of a suspected ovarian neoplasm is the standard procedure. In most institutions, the type of surgery performed (laparoscopy vs laparotomy) depends on the probability of
malignancy (Koonings et al., 1989).