OBJECTIVE :

Our purpose was to investigate the diagnostic accuracy of transvaginal ultrasonography (TVUS),color doppler ultrasonography(CDUS) and CA-125 assay in postmenauposal women undergoing laparotomy - laparoscopy for a clinical diagnosis of an adnexial mass.

MATERIAL AND METHODS :

We performed TVUS for 7500 natural postmenopausal patients in routine control examination between 1997-2001. We found 94 adnexial masses which were > 5 cm at TVUS. DePriest ultrasonographic morphology index, CDUS and serum CA-125 examinations were done.

RESULTS :

The mean age of patients was 56 (45-71) and the mean menauposal age was 52. We found 94 adnexial masses which were > 5 cm. at TVUS (% 1.25). De Priest ultrasonographic morphology index, serum CA-125 levels and CDUS examinations were done for these patients. De Priest morphology index was higher than 4 in 23 ptients (8.46 +/- 2.18). Pulsality index (PI) was < 1 in 23 patients and serum CA-125 levels were > 35 UI. These 23 patients were accepted as suspected group for ovarian cancer and laparotomy was performed. Ten of 23 patients were reported as ovarian cancer. Eight of them were malign ovarian and 2 of them were borderline tumors.

CONCLUSION :

We recommend TVUS screening in the routine control examinations of natural postmenauposal women. The technic is noninvasive, well accepted by the patients and cost effective. Postmenauposal women have high risk for the ovarian cancer. Routine postmenauposal examination sould be considered as a chance of cancer screening studies. TVUS could easily be performed during the pelvic examination and in suspected cases (>5 cm mass), combination of morphology index, CDUS, serum CA-125 analysis improve the positive predictive value of TV US for detecting the ovarian malignancies.

Keywords: Adnexial Mass, Transvaginal Ultrasonography, Color Doppler Ultrasonography, CA-125, De Priest Index, Menopause