Preoperative evaluation of ovarian tumors in the premenopause by transvaginosonography.

Abstract

The aim of the study was to establish reproducible sonomorphologic criteria by use of transvaginosonography in the preoperative evaluation of ovarian tumors in the premenopause. In a prospective study from 1987 to 1993 we investigated 1072 ovarian tumors. All tumors > or = 3 cm were included in the study. To avoid unnecessary operations, all tumors we rescanned after 6 weeks. The sonomorphologic criteria were correlated with the histologic findings. A total of 4.3% of ovarian tumors in the premenopause were malignant. In the special group of sonographically simple ovarian cysts we found 0.8% malignancies. The incorporation of a control scan after 6 weeks in the management of ovarian cysts reduces the number of unnecessary operations on functional cysts. Only 5.5% of the functional tumors were operated on. The risk for malignancy in cystic-solid ovarian tumors is 17.0%, the highest of all sonomorphologic tumor types. The use of reproducible sonomorphologic criteria in combination with a control scan in premenopausal women with ovarian cysts proved to be efficient to reduce the number of unnecessary operations and to evaluate the risk for malignancy.