Using sonography, we classified the adnexal masses of 292 patients into 4 p
atterns. Pattern A was benign cystic tumors; B was benign mixed tumors (cys
ts with a smooth solid component); C was malignant mixed tumors (cysts with
an irregular solid component or thickened septum), and D was solid tumors.
We diagnosed tumors showing patterns A and B as benign, while patterns C a
nd D represented tumors with low malignant potential or actual malignancy.
The sensitivity and specificity of sonography was 82.2 and 82.1%, respectiv
ely, and these values were superior to those for tumor markers (CA125, CA19
-9, CA72-4). Both the sensitivity and specificity of intraoperative frozen
sections were the highest, showing that this is the most reliable examinati
on. However, 15 of 191 patients undergoing frozen section were upgraded by
the final pathological diagnosis. If sonography is performed by an experien
ced gynecologic oncologist, this examination is more reliable than tumor ma
rkers. However, intraoperative frozen section should still be performed dur
ing surgery for patients with ovarian tumors. Copyright (C) 2001 S. Karger