E1896. Management of Incidental Adnexal Lesions: A Case-Based Review
  1. Hagar Mahmoud; Nazareth Hospital
  2. Sarah Palmiquist; MD Anderson Cancer Center
  3. Priya Bhosale ; MD Anderson Cancer Center
  4. Wui Chong; MD Anderson Cancer Center
1-Incidental adnexal findings are common on CT and MR examinations of the female pelvis. 2- Potential incidental CT or MR findings in many premenopausal women are common owing to the normal physiologic changes as monthly development of a dominant follicle and subsequent corpus luteum, in addition to non-neoplastic cysts that may vary in size in postmenopausal women. 3-Developing an algorithmic approach based on patient characteristics and imaging features was needed for the characterization of incidental findings and improving the quality of care by offering guidance on how to manage incidentally detected adnexal masses.

Educational Goals / Teaching Points
1- Adnexal masses can be categorized based on patient characteristics and imaging features. 2- An algorithm is described to manage adnexal masses incidentally detected on CT and MRI based on the ACR incidental finding committee (IFC) recommendations.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1- Required elements to characterize incidental adnexal masses on CT and MRI: A. Mass characteristics (simple appearing cyst, features indicating a specific diagnosis, indeterminate features) B. Size C-Technical consideration D-Menopausal status

-Incidental adnexal findings on CT and MR examinations of the female pelvis are common -Overview of the algorithm for management of the incidental adnexal mass based on whether the mass is (1) a simple-appearing cyst; (2) has reasonably diagnostic imaging features; or (3) has an uncertain diagnosis. - Simple-appearing cysts on CT or MR carry a very low risk of malignancy, thus imaging follow-up is required only when the cyst is relatively large for the patient’s menopausal status. -The main goals of imaging follow-up are to limit the risk of cyst mischaracterization and to understand the rate of cyst growth, which may affect the subsequent clinical decision-making.